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AFFIDAVIT / STATUTORY DECLARATION
MAKER AND RECIPIENT
Full name of deponent or declarant: ________
Residential or business address: ________
Occupation: ________
Email address or telephone number: ________
Capacity in relation to the matter: ________
Intended recipient: ________
Matter or application reference: ________
Subject of evidence or declaration: ________
DOCUMENT SELECTION AND COMPLETION
1. Selection of document. This template provides alternative forms of execution for a witnessed Commonwealth statutory declaration and an affidavit. Retain only the applicable opening and execution block. A statutory declaration does not become an affidavit merely by changing its title, and an affidavit must be sworn or affirmed before a person authorised for the relevant jurisdiction.
Selected document type: ________
2. Commonwealth statutory declaration. Use the Commonwealth alternative where a declaration under the Statutory Declarations Act 1959 is appropriate for the intended purpose. The declarant must use the approved form and sign under the observation of a prescribed person. The Commonwealth alternative below incorporates the approved declaration and warning. ([Attorney-General's Department][1])
3. State or territory requirement. Where the recipient requires a declaration under a State or Territory law, use that jurisdiction’s prescribed form, declaration wording and witnessing requirements. Do not retain the Commonwealth opening or offence warning as a substitute for those requirements. The location of signing alone does not determine which declaration the recipient requires.
Required State or Territory, if applicable: ________
Required local form and enabling legislation, if applicable: ________
4. Affidavit requirement. For an affidavit, incorporate the evidence into the form required by the receiving court or tribunal, including its heading, jurat and any special certificates. For Federal Court proceedings, Form 59 and Part 29 of the Federal Court Rules 2011 apply. This combined template is not itself a universally prescribed Australian court form. ([legislation.gov.au][2])
5. Completion of evidence. Retain only paragraphs that are relevant and true, remove unused alternatives and renumber the evidence consecutively before execution. Each paragraph should address a distinct factual subject. Do not sign a document containing uncompleted fields, unsupported assertions or an attachment that has not been identified and reviewed.
6. Nature of instrument. This instrument records evidence or declared facts; it does not itself establish a contract for services, a price, a payment obligation, a contractual duration or a termination right. Include financial terms, dates or notice periods only where they form part of the facts being proved, rather than creating obligations through this instrument.
7. Personal information. Include identifying information only where it is relevant to the matter or required by the applicable form or recipient. This instrument does not grant unrestricted consent to use personal information or override applicable privacy obligations, confidentiality duties, legal professional privilege or court restrictions on disclosure.
8. Witnessing a Commonwealth declaration. For the Commonwealth alternative, the witness must qualify under the Statutory Declarations Regulations 2023. Signing may occur in person or through a live audiovisual link, with the witness observing the declarant sign and both participants signing during the same witnessing session. ([legislation.gov.au][3])
9. Overseas and electronic execution. An overseas location does not remove the requirement for an appropriately qualified witness. A foreign professional title alone does not establish qualification to witness a Commonwealth declaration. Electronic signing must satisfy the applicable law; typing names into this template does not establish that observation or administration of an oath occurred.
10. Correction and subsequent use. Complete corrections before execution and authenticate them as required by the applicable procedure. Do not alter the executed evidence. If a material error is discovered later, prepare a properly executed correcting or supplementary instrument and comply with any applicable filing, service or recipient requirements.
11. Applicable procedure and disputes. The selected legislation and the receiving court’s or authority’s applicable requirements govern execution and use. This instrument does not select an exclusive contractual forum, impose arbitration, exclude statutory liability or restrict a court’s power to assess admissibility, require attendance or determine the weight of the evidence.
12. Assembly of final instrument. Remove these completion provisions from the instrument to be executed. Retain the maker’s particulars, the applicable heading and opening, the relevant numbered evidence, identified attachments and the applicable execution block. Any required court heading must appear in the position prescribed by the relevant court form.
OPTIONAL COURT HEADING — AFFIDAVIT ONLY
Court or tribunal: ________
Division or list: ________
Registry: ________
Proceeding number: ________
Applicant or plaintiff: ________
Respondent or defendant: ________
Other parties and their procedural capacities: ________
Filed on behalf of: ________
Capacity of filing party: ________
Prepared by: ________
Address for service: ________
Contact telephone number: ________
Contact email address: ________
Contact fax number, if applicable: ________
Affidavit of: ________
Occupation: ________
Address: ________
Date sworn or affirmed: ________
COMMONWEALTH OPENING — RETAIN FOR COMMONWEALTH STATUTORY DECLARATION ONLY
COMMONWEALTH OF AUSTRALIA
STATUTORY DECLARATION
Statutory Declarations Act 1959
I, full name: ________
Address: ________
Occupation: ________
make the following declaration under section 9 of the Statutory Declarations Act 1959:
AFFIDAVIT OPENING — RETAIN FOR AFFIDAVIT ONLY
AFFIDAVIT
I, full name: ________
Address: ________
Occupation: ________
say on oath or solemnly and sincerely affirm, according to the method recorded in the jurat, that the following evidence is true.
EVIDENCE
1. Identity and connection with the matter. I am the person identified above. My involvement in the subject matter, including the capacity in which I acted and the circumstances through which I became acquainted with the relevant events, is as follows. Connection with the matter: ________
2. Purpose and scope. I make this instrument for the matter identified above. The particular facts I seek to establish and the purpose for which I provide them are set out below. My account is confined to those matters and the supporting circumstances necessary to understand them. Purpose and facts to be established: ________
3. Personal knowledge. Except where I expressly identify another source, the matters stated in this instrument are within my own knowledge. The circumstances in which I personally observed, participated in or recorded the relevant events are set out below. Basis of personal knowledge: ________
4. Relevant background. The following background explains the circumstances existing before the principal event or issue addressed in this instrument. I distinguish matters I observed from matters recorded in documents and identify any limitation on my recollection. Relevant background and limitations: ________
5. Principal event. My account of the principal event identifies what occurred, who was involved, where it happened and the sequence of actions I personally observed or performed. Any date or time that is approximate is expressly described as approximate in that account. Principal event details: ________
6. Subsequent events. The following account describes the relevant events after the principal event, including actions I took and responses I personally received or observed. Where no subsequent event is relevant, I expressly state that fact rather than imply that an investigation or enquiry occurred. Subsequent events: ________
7. Communications. The following details identify relevant communications, their participants and the circumstances in which they occurred. I distinguish words reproduced from a record from the substance of a conversation recalled from memory and do not present an approximate recollection as a verbatim quotation. Communication details: ________
8. Supporting records. I identify below the documents or other records supporting my account, how I obtained them and whether they are originals, complete copies or extracts. Any missing pages, redactions or other limitations affecting the material I rely upon are expressly identified. Records and provenance: ________
9. Information from another source — optional. The following statements are based on information provided by an identified person or record rather than my personal observation. I identify the relevant statement, its source and my grounds for believing it, subject to the applicable rules concerning admissibility. Statements, sources and grounds: ________
10. Qualifications and contrary facts. The following matters qualify, correct or explain my account, including any relevant uncertainty or fact known to me that is inconsistent with a statement I have made. If there is no such matter known to me, I expressly state that position without claiming knowledge beyond my own. Qualifications and contrary facts: ________
11. Earlier account — optional. If I previously provided an account of this matter, I identify that account and explain any material difference between it and this instrument. I identify the particular statement corrected and the reason for the correction, without suggesting that the earlier account has been erased or withdrawn from any official record. Earlier account and corrections: ________
12. Review and adoption. I have read the completed instrument, or it has been accurately read or interpreted to me, and I understand its contents. I have reviewed the attachments identified as supporting my account. Any assistance, interpretation or limitation affecting that review is described below. Review and assistance details: ________
OPTIONAL CORPORATE CAPACITY PARTICULARS
Complete only where the maker’s corporate role is relevant. The maker gives the evidence personally; the company does not swear an oath or make a declaration through a corporate execution block.
Company name: ________
Australian Company Number or other registration identifier: ________
Registered office address: ________
Representative’s full name: ________
Representative’s position: ________
Basis of authority and access to company records: ________
OPTIONAL FINANCIAL FACTS
Include only where relevant to the evidence. These particulars record the asserted transaction and do not independently acknowledge a debt, vary a contract or authorise payment.
Transaction or obligation described: ________
Currency: ________
Principal amount: ________
GST amount, if relevant: ________
Amount paid: ________
Amount asserted to remain unpaid: ________
Payment due date: ________
Basis of calculation and supporting record: ________
OPTIONAL ATTACHMENT IDENTIFICATION
Attachment identifier: ________
Document description: ________
Document date: ________
Number of pages: ________
Relevant evidence paragraph: ________
For an affidavit, place the required identification certificate on each annexure or exhibit and reproduce the court heading where required. Repeat this block for each attachment with a distinct identifier.
This is the document identified below and referred to in the affidavit of the deponent named below, sworn or affirmed on the date stated below before me.
Attachment identifier: ________
Deponent’s full name: ________
Date sworn or affirmed: ________
Certifying witness’s full name: ________
Certifying witness’s qualification: ________
Certifying witness’s signature: ________
OPTIONAL INTERPRETER CERTIFICATE
Retain only where interpretation was required and the certificate is suitable for the receiving jurisdiction. Complete any separately prescribed interpreter affidavit or certificate where required.
Interpreter’s full name: ________
Interpreter’s address: ________
Language and dialect: ________
Qualifications or basis of competence: ________
Interpretation difficulties, or confirmation that none arose: ________
Place of interpretation: ________
Date of interpretation: ________
Interpreter’s signature: ________
OPTIONAL AFFIDAVIT READING CERTIFICATE
Retain where required by the applicable rules and where accurate.
I certify that this affidavit was read to the deponent in my presence, that the deponent appeared to understand its contents and that the deponent swore or affirmed its truth. Any inability to sign and the method by which execution was completed are recorded below.
Reason reading assistance was required: ________
Execution assistance and applicable authority, if relevant: ________
COMMONWEALTH STATUTORY DECLARATION — EXECUTION
Retain this block only for a Commonwealth statutory declaration.
I believe that the statements in this declaration are true in every particular, and I understand that a person who intentionally makes a false statement in a statutory declaration is guilty of an offence under section 11 of the Statutory Declarations Act 1959, the punishment for which is imprisonment for a term of 4 years.
Signature of person making the declaration: ________
Email address or telephone number of person making the declaration: ________
Declared at — place: ________
On — date: ________
Observed by me,
Signature of person observing the declaration being made: ________
Full name of person observing the declaration being made: ________
Qualification of person observing the declaration being made: ________
Address of person observing the declaration being made: ________
AFFIDAVIT — JURAT AND EXECUTION
Retain this block only for an affidavit and use the jurat required by the receiving court or tribunal. Administer the selected oath or affirmation; the deponent’s signature alone is insufficient.
Method of making affidavit — sworn or affirmed: ________
Sworn or affirmed by the deponent named below at the place and on the date stated below, before me.
Deponent’s full name: ________
Place of swearing or affirmation: ________
Date sworn or affirmed: ________
Deponent’s signature: ________
Before me,
Authorised witness’s full name: ________
Authorised witness’s qualification and authority to administer the oath or affirmation: ________
Authorised witness’s address: ________
Witness’s place of attendance: ________
Date of witnessing: ________
Authorised witness’s signature: ________
Fields you complete are inserted into the document live. This template is general guidance only - not legal advice.