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Statutory Declaration of Loss of a Receipt
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STATUTORY DECLARATION OF LOSS OF A RECEIPT
I, ______, of ______, in the Province of Ontario, SOLEMNLY DECLARE that:
On ______, I paid ______ to ______ for ______.
The receipt or proof of payment was lost in the following circumstances: ______.
I have made diligent efforts to locate it without success, and the payment described above was genuinely made.
Purpose of this declaration (if specified):
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.
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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