Affidavits
Vaccination Status Affidavit
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Vaccination Status Affidavit
I, ______, of the city of ______, in the province/state of ______, DO SOLEMNLY DECLARE AND STATE:
I was born on ______ in ______.
I hereby swear or affirm that I received the following vaccines:
Vaccine Name: ______
Date Vaccine Received: ______
I swear this Affidavit in support of my submission to ______, and for no improper purpose.
I am a ______ of Canada.
AND I make this solemn declaration conscientiously believing it to be true, and knowing that it is of the same force and effect as if made under oath and by virtue of the Canada Evidence Act.
Signed and sworn (or affirmed/declared) before me by videoconference in Ottawa, Ontario, while the Affiant(s)/Declarant(s) were located in ______________________, on ______________________, pursuant to O. Reg. 431/20, and Electronic Commerce Act, 2000.
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