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Statutory declarations
A sworn statement that you provide care to a dependent adult — useful to support care, tax credit, or benefit applications.
Also known as
STATUTORY DECLARATION OF CAREGIVER FOR A DEPENDENT ADULT
I, ______, of ______, in the Province of Ontario, SOLEMNLY DECLARE that:
I provide care and support to ______, who is my ______.
I have provided this care since ______. The care and support I provide includes: ______.
Our living arrangement is: ______.
I make this declaration to support a care, credit, or benefit matter, for the following purpose: ______.
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.
DECLARED before me at the ______________________ of ______________________, in the Province of Ontario, this ______ day of ______________, 20______.
_______________________________ _______________________________
A Commissioner for taking Affidavits Signature of Declarant
How it works
Answer the questions on the left. Your document builds itself on the right as you type.
Get a clean, ready-to-sign PDF in seconds. No account, no watermark.
Book an appointment, bring your document, and we witness your signature and apply the seal.
It is a sworn statement describing the care and support you provide to a dependent adult, such as an aging parent or a relative with a disability.
Programs and credits sometimes require sworn confirmation of the caregiving relationship.
You may need it when:
Have ready:
Fill in the form and download a clean, ready-to-sign PDF. Do not sign it yet — it must be signed in front of a notary public or commissioner for taking affidavits.
Book an appointment with Minute Notary. We administer your oath or affirmation, witness your signature, and apply the seal — online where eligible, or in person in Ottawa.
Frequently asked
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