Statutory declarations
Statutory Declaration of Caregiver for a Dependent Adult
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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. Specific purpose (if any):
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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