To navigate through the ribbon, use standard browser navigation keys. Id like to know more about the difficulties you are experiencing with completing this form. Download a word or pdf copy of a statutory declaration. Fill out, securely sign, print or email your download statutory declaration form instantly with signnow. Editable word doc doc 43kb uneditable pdf pdf 12kb. Continuing education allowances public health system. I understand that a person who intentionally makes a false statement in a statutory declaration is guilty of an offence under section 11 of the. This means that you should not change or delete the wording of the statutory declaration or it may not comply with the legislative requirements for statutory.
I acknowledge that continued employment with a nsw health agency is conditional upon a satisfactory outcome of the check which i have consented to. I name, do solemnly and sincerely declare that and i make this solemn declaration conscientiously believing the same to be true, and by virtue of the provisions of the oaths act 1900. In australia a stat dec can be made under state law or commonwealth law depending upon the circumstances requiring the document. Commonwealth statutory declaration last modified by. An organisations roads and maritime services customer number is found on the vehicles registration papers. Declarations, a notary public, a person before whom a statutory declaration may be made under the law of the state in which the declaration is made, an australian consular officer or an australian diplomatic officer as defined by section two of the consular fees act 1995, a chiropractor. The most secure digital platform to get legally binding, electronically signed documents in just a few seconds. Statutory declaration oaths act 1900, nsw, ninth schedule i, of. Download and create your own document with statutory declaration form nsw 8kb 1 pages for free. Occupation i acknowledge that this declaration is true and correct and i make it in the belief that a person making a false declaration is liable to the penalties of perjury. We acknowledge aboriginal people as the first nations peoples of nsw and pay our respects to elders past, present, and. However, a justice of the peace cannot charge a fee to witness a statutory declaration.
We own and maintain 5 aquatic centres, 34kms of bike paths, 15km of the great blue mountains trail, 7 cliff sport precincts, 6 skate parks, 6 natural campgrounds and 2 tourist parks. Contact us the hills shire council 3 columbia court, norwest nsw 2153. Documents and forms registration maritime roads and. State government, a credit card or account or a passbook or statement of. Statutory declaration fill out and sign printable pdf. Nsw health service consists of those persons who are employed under chapter 9, part 1 of the health services act 1997 by the government of new south wales in the service. You can be fined and lose your driving privileges if you make a false nomination. Attachment 9 hepatitis b statutory declaration author. I, make the following statutory declaration under the oaths and affirmations act 2018. For additional information on the statutory declarations please see. Or, if they are registered to practice their work in australia. Statutory declaration oaths act 1900, new south wales, eighth schedule. A person who is licenced or registered in these occupations.
A nsw statutory declaration is made under the oaths act 1900. Use this template to create a statutory declaration for the state of victoria. A statutory declaration in the state of new south wales. The act contains 2 alternative formats for a statutory declaration, and you.
Nsw statutory declaration form pdf the above referred document contains the latest jurat. Documents and forms related to nsw vessel registration. Commonwealth of australia statutory declaration form subject. Australian health practitioner regulation agency common. Use this form to provide evidence of your aboriginality if you are not able to get confirmation from a local aboriginal land council or an aboriginal community organisation download confirmation of aboriginality statutory declaration dh0165 pdf file. Commonwealth statutory declaration form your experience.
Use this form to provide evidence of your aboriginality if you are not able to get confirmation from a local aboriginal land council or an aboriginal community organisation. To make a statutory declaration, download and complete the statutory declaration form below. Allied health practitioner application for sira workers compensation approval static application for approval of preinjury average weekly earnings agreement application to endorse or delete a subsidiary on a selfinsurer licence. Some documents on this page may not comply with accessibility requirements wcag.
Commonwealth of australia statutory declaration form. Statutory declarations department of justice and community. National animal heath declarations are a way for producers to provide information about the animal health status of their flocks and herds. Completed and signed nsw health blood born virus student declaration form. With the announcement of the new pandemic subregister, we are receiving a high volume of calls.
Coronavirus covid19 and the attorneygenerals department. Statutory declarations act 1959, and i believe that the statements in this declaration are true in every particular. You can download a blank statutory declaration form from the australian. If your enquiry is about the subregister please first check our subregister faqs page. Statutory declaration, free stat dec form australia. I saw the face of the person or i did not see the face of the person because the person was wearing a face covering, but i am satisfied that the person had a special justification 1. Please print out the form s you need, fill in, sign, and email to dgrp. Occupational assessment, screening and vaccination against specified infectious diseases summary this policy directive provides a framework for the assessment, screening and vaccination of health care workers, other clinical personnel and students to minimise the risk of transmission of vaccine preventable diseases. To accompany an application for a licence under the. Other employment form only complete if required statutory declaration only complete if required employee leave election form only complete if required 10 hour waiver form nursing only please send your completed forms via email to the employee services unit. Criminal record statutory declaration australia 1 to be completed by a locum medical officer in relation to requirement 5 of the locum medical officer preplacement checklist form 1. Stat dec for declaration in the state of new south wales. Nsw statutory declaration forms service nsw nsw government.
Fill, sign and download statutory declaration form online on. You can type or write the statutory declaration before visiting an authorised witness, but dont sign it yet. The declarant is the name of the person or company that the penalty notice has been originally addressed to. All completed documents are to be combined into one pdf file as an email. This is in document form, useful if you wish to simply print. There are two alternative formats specified in the act, in the. A statutory declaration is a written statement that a person signs and declares to be true and correct before an authorised witness. Each state and territory, except the australian capital territory, have their own legislation. Under the eight schedule of the oaths act 1900 nsw it is now the same for those who have a god and those have no religion or no god. How to complete an australian statutory declaration a statutory declaration is a legal document that is required by law to contain specific wording, that is, it is a prescribed form.
Nsw statutory declaration forms justices of the peace. They should advise the nsw health agency if they prefer to provide this information in private consultation with a clinician. Commonwealth of australia department of home affairs. Health statistics nsw is an interactive webbased application. Commonwealth of australia statutory declaration nsw health. I understand that a person who intentionally makes a false statement in a statutory declaration is. It allows users to access data about the health of the new south wales population and tailor these data for their own use. Find out how our services are being delivered and how you can access them. These people can witness your statutory declaration if they are licenced in australia. Fillable and printable statutory declaration form 2020.
Ccdc 9a 2018 statutory declaration of progress payment distribution by contractor is a sworn statement for use by the contractor as a condition of receiving payment for either the second and subsequent applications for progress payment or the release of holdback funds. I saw the face of the person or i did not see the face of the person because the person was wearing a face covering, but i am satisfied that the person had a special justification. Qld statutory declaration, oaths act 1867, stat dec, statutory declaration, queensland, form, created date. Incoming student document checklist preregistration. Send the form to us at the address that appears on the form. A statutory declaration is a written document that must be completed in front of an authorised witness. The regulatory and compliance support unit nsw environment protection authority po box a290 sydney south nsw 1231. Occupational assessment, screening and vaccination against specified infectious diseases summary this policy directive provides a framework for the assessment, screening and vaccination of health care workers, other clinical personnel and students to minimise the risk of.
For covid19 news, updates and advice from the australian government, visit australia. Statutory declaration i full name of address do solemnly and sincerely declare that. A statutory declaration is a sworn or affirmed statement and is usually used where there are no court proceedings but some fact needs to be proved. A statutory declaration is a written statement which a person swears, affirms or declares to be true in the presence of an authorised witness usually a justice of the peace, a lawyer or a notary public. Statutory declaration dh1030, english pdf file 140. Occupational assessment, screening and vaccination against. A statutory declaration is a written statement which a person swears, affirms or declares to be true in the presence of an authorised witness usually a jp, lawyer or notary public. Please share here and i see if i can make life a little easier for everybody.
Declared at in the state of victoria this day of 20. You may be given a declaration form to fill in or you can write it yourself. I understand that a person who intentionally makes a false statement in a statutory declaration is guilty of an offence under section 11 of the statutory declarations. A list of all approved identity documents and a list of persons qualified to be a witness is attached from september 2018. Statutory declarations are used for many purposes, including. The act contains 2 alternative formats for a statutory declaration, and you can use whichever is more suitable for your needs. Apr 22, 2020 download a commonwealth statutory declaration here to support your visa application.
Confirmation of aboriginality statutory declaration dh0165, english. Statutory declaration of acknowledgement of parentage form. Fill out, securely sign, print or email your png declaration form instantly with signnow. Who can witness your statutory declaration attorneygeneral. Commonwealth statutory declaration form pdf 81kb commonwealth statutory declaration form. Commonwealth of australia, statutory declaration, stat dec, declartion, form category. Commonwealth statutory declaration form pdf statutory declaration for electronic copies pdf nsw seniors card application form.
Common forms australian health practitioner regulation agency. Its your responsibility to make sure your declaration is correct and meets all the necessary legal requirements. Download a statutory declaration attorneygenerals department. Download a statutory declaration download a word or pdf copy of a commonwealth statutory declaration. Occupation and i make this solemn declaration conscientiously believing the same to be true, and by virtue of the provisions of the oaths act, 19361969. Statutory declarations attorneygenerals department. A blank stat dec form for declaration under the oaths, affidavits and declarations act 2010 nt in the northern territory.
By signing it, you agree that the information in it is true, and you can be charged with perjury if the information is false. Making a statutory declaration new zealand government. Confirmation of aboriginality statutory declaration dh0165. Where an adjudication body in nsw has imposed the reprimand under the national. Statutory declaration form local court of new south wales. Opt 011 subcontractors statement regarding workers compensation, payroll tax and remuneration november 2019 1 of 2 subcontractors statement regarding workers compensation, payroll tax and remuneration note 1 see back of form for the purposes of this statement a subcontractor is a person or other legal entity that has entered into a. I declare that the contents of this statutory declaration are true and correct and i make it knowing that making a statutory declaration that i.
It provides information on health status, inequities and determinants of health. Statutory declaration for the state of victoria health. Statutory declaration for the state of victoria pdf, kb. Examples of when statutory declarations might be used include. Statutory declaration form australia statutory declaration. A blank stat dec form for declaration in the state of new south wales. This declaration is to be completed and signed by a person making a statement. Useful forms for jps nsw statutory declaration form pdf the above referred document contains the latest jurat. Any authorised witness for the state of western australia may also witness a commonwealth statutory declaration, as long as they are in western australia at the time of witnessing schedule 2, item 231 of the statutory declarations regulations 1993 commonwealth. Templates for a statutory declaration are also available in either pdf form or editable doc form on the nsw.
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