Statutory Declaration of No Income

STATUTORY DECLARATION OF NO INCOME

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

1. During the period ______, I received the following income: ______.

2. During that period I supported myself by the following means: ______.

3. 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