<p> STATUTORY DECLARATION TEMPLATE</p><p>DISCLAIMER The sample and free documents on this webpage ("the sample documents" and “free documents”) are designed to be used only as example documents. Legal E Docs, on behalf of itself and any other person or entity involved in the production of the sample and free documents, disclaims any liability arising out of or in connection with the use of the sample or free documents or reliance on their contents by any person or other entity, whether used in the original form or altered in some way by the user. Users are authorized to use the sample and free documents only for their own informational purposes only. Any other use of the sample or free documents is prohibited. Legal E Docs gives no warranties nor makes any representations in respect of the sample or free documents including, without limitation, any warranties as to quality, standard or legal efficacy. If a user is dissatisfied with any portion of the sample or free documents, or with any of these terms of use, their sole and exclusive remedy is to discontinue using the sample and free documents. The sample and free documents and information contained within them is not intended to and does not constitute legal, financial, taxation or other professional advice. Before using any of the sample and free documents in practice, appropriate professional advice must be obtained.</p><p>State of Victoria – Evidence Act 1958 STATUTORY DECLARATION</p><p>I, [INSERT FULL TIME] Of [INSERT ADDRESS AND OCCUPATION], do solemnly and sincerely declare that [INSERT MATTERS TO BE DECLARED]</p><p>I acknowledge that this declaration is true and correct, and I make it with the understanding and belief that a person who makes a false declaration is liable to the penalties of perjury.</p><p>Declared at ______in the State of Victoria, this ______day of</p><p>______20 ____ ...... Signature of person making this declaration</p><p>[to be signed in front of an authorised witness]</p><p>Before me,</p><p>...... Signature of authorised witness</p><p>The authorised witness must print or stamp his or her name, address, and title under section 107A of the Evidence Act 1958 [Vic.] (eg. Justice of the Peace, Pharmacist, Police Officer, Court Registrar, Bank Manager, Medical Practitioner, Dentist)</p>