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Trans-Tasman Occupations Tribunal

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Statutory Declaration(New Zealand)

What is this form for? Use this form to verify your documentation by Statutory Declaration.

Important Information 1. This form must be signed in New Zealand by a Deputy Registrar/Registrar of the High Court or any District Court, Justice of the Peace, or Solicitors or Notary Public or Officer authorised to take and receive Statutory Declarations. This form can also be signed by a person qualified to take a Statutory Declaration, in accordance with Australian law. 2. You must post this form with your application to the Tribunal address at the end of this form.

Please fill in all sections below

I (Name in full)

of (Address in full)

(Occupation)

Do solemnly and sincerely declare that: (please state the facts of your declaration)

And make this solemn declaration conscientiously believing the same to be true, and by virtue of the Oaths and Declarations Act 1957.

Signature of declarant

Declared at / / (day / month / year)

Before me (name)

(signature)