Application For Suspension Of An Enforcement Order - Department Of Justice - Tasmanian Government Page 2

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OATHS ACT 2001
STATUTORY DECLARATION
I, …………………………………………………………………………………….
………………………………………………………………………………………
(name, address and occupation)
do solemnly and sincerely declare that ……………………………………………..
………………………………………………………………………………………
………………………………………………………………………………………
………………………………………………………………………………………
………………………………………………………………………………………
………………………………………………………………………………………
………………………………………………………………………………………
………………………………………………………………………………………
………………………………………………………………………………………
(facts)
I make this solemn declaration under the Oaths Act 2001.
at …………………………………………………………….
Declared
(place)
………………………………………………………………………
on
(date)
…………………………………………………….
Signature
Before me,
.…………………………………………………..
(Justice, commissioner for declarations or
authorised person)

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