Immigration & passport
Statutory Declaration of Name Discrepancy
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STATUTORY DECLARATION OF NAME DISCREPANCY
I, ______, of ______, in the Province of Ontario, DO SOLEMNLY DECLARE that:
My name as it appears on my ______ is ______.
My name as it appears on my ______ is ______.
Both names refer to one and the same person, namely myself. I have never used the differing versions of my name for any improper purpose, and I am not attempting to conceal my identity.
The discrepancy arose because: ______.
My date of birth is ______, and my place of birth is ______.
Other names or spellings I have used (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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