Open daily: 9:00 AM - 8:00 PM
other
A sworn statement that you did not receive goods, a payment, or an item you were expecting — useful to support a dispute, refund, reissue, or insurance claim.
Also known as
STATUTORY DECLARATION OF NON-RECEIPT
I, ______, of ______, in the Province of Ontario, SOLEMNLY DECLARE that:
I was expecting to receive the following ______: ______, from ______.
It was expected on or about ______, with an amount or value of ______.
I did not receive it. The circumstances, and what I have done about it, are as follows: ______.
To the best of my knowledge, the item has not come into my possession or control.
I make this declaration to support a refund, reissue, or claim, 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 that something you were expecting — a package, a payment, or another item — never reached you.
It is used to support a refund, a reissue, a chargeback, or an insurance or delivery claim.
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
Keep exploring
Other documents for identity & personal status.
A sworn statement by someone who knows you, confirming your identity and particulars — useful where a person cannot prove their identity with standard documents.
Fill it outA sworn statement explaining why something was filed or done late — used to support a request to accept a late application or excuse a delay.
Fill it outA sworn statement by a witness who saw a document signed — confirming the signing took place and that the signer appeared to act freely. Commonly required to prove a document was properly executed.
Fill it outProvide a notarized sworn statement confirming your commitment to financially support a student's education in Ontario. Frequently required by schools, OSAP, immigration offices, or scholarship committees as proof of sponsorship.
Fill it outFill it in online, download a ready-to-sign PDF, then bring it in and we will notarize it, in person across Ottawa or online.