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A sworn statement that you have surrendered or destroyed a document (such as a licence, permit, or certificate) — used when an authority requires confirmation of return.
Also known as
STATUTORY DECLARATION OF SURRENDER OF A DOCUMENT
I, ______, of ______, in the Province of Ontario, SOLEMNLY DECLARE that:
I was the holder of the following document: ______ (reference number: ______).
On ______, the document was ______, ______.
The reason and circumstances are as follows: ______.
The document is no longer in my possession or control.
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
How it works
Answer the questions on the left. Your document builds itself on the right as you type.
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Book an appointment, bring your document, and we witness your signature and apply the seal.
A Statutory Declaration of Surrender of a Document confirms under oath that you have surrendered, returned, or destroyed a document such as a licence, permit, or certificate.
Authorities request it when they need confirmation a document is no longer in your possession.
You may be asked for this document in situations such as:
Have the following details ready before you start:
Fill in the form on this page and download a clean, ready-to-sign PDF. Do not sign it yet — an affidavit or statutory declaration must be signed in front of a notary public or commissioner for taking affidavits.
When you are ready, book an appointment with Minute Notary. We administer your oath or affirmation, witness your signature, and apply the notarial seal. Where the document is eligible, you can do this online from anywhere in Ontario; otherwise we meet in person in Ottawa.
Frequently asked
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