Statutory Declaration of Employment and Income

STATUTORY DECLARATION OF EMPLOYMENT AND INCOME

I, ______, of ______, in the Province of Ontario, SOLEMNLY DECLARE that:

1. I am employed by ______.

2. My position is ______, and I have been employed there since ______.

3. My income from this employment is ______ ______.

4. I make this declaration 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.

SWORN / DECLARED before me at the ______________________ of ______________________, in the Province of Ontario, this ______ day of ______________, 20______.

_______________________________ _______________________________

A Commissioner for taking Affidavits Signature of Declarant