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Statutory Declaration

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STATUTORY DECLARATION
Prepared October 23, 2026 · Ontario, Canada
RECITALS
WHEREAS the undersigned desires to set out in writing the matters described below;
WHEREAS this document has been prepared with reference to the laws of Ontario, Canada;
NOW, THEREFORE, the following provisions shall apply:
Ontario, Canada
I, Jordan Miller, of 123 Example Street, Toronto, ON M4B 1B3, born 1988-04-17, solemnly declare that:
I make this declaration concerning the document described below, which was lost or destroyed. I have not assigned, sold, pledged, or otherwise parted with that document, and if it is found I will return it to the issuing authority. Document concerned: Lost Canadian passport booklet
1. I am the holder of Canadian passport number AB123456 (example), issued to me in Toronto.
2. On or about September 28, 2026, I lost the passport while travelling between Toronto and Montreal; I do not know where it is.
3. I have searched my home, luggage and vehicle thoroughly and have been unable to find it.
4. I reported the loss to Passport Canada and to the Toronto Police Service (report #2026-EX-1042).
5. If the passport is found, I will return it to Passport Canada immediately and will not attempt to travel on it.
AND 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, and by virtue of the Canada Evidence Act.
Declared before me at Toronto, Ontario, Ontario,
on October 23, 2026.
___________________________
Declarant
Jordan Miller
___________________________
Commissioner of Oaths / Notary Public
(Print name and stamp/seal below)
IMPORTANT — READ BEFORE SIGNING
A statutory declaration has NO legal effect until it is signed in the physical presence of a commissioner of oaths, notary public, or other person authorized to administer oaths in Ontario.
Making a false statement in a statutory declaration is a criminal offence (perjury).
Do NOT sign this document until you are in front of the commissioner/notary — they must witness your signature.
Bring government-issued photo ID. The commissioner may charge a small fee.
If the declaration will be used outside Canada, ask whether additional authentication ("apostille"-style legalization) is required.
This is a self-help template, not legal advice.
IN WITNESS WHEREOF, the undersigned has duly executed this document as of the date first written above.
Executed by:
Signature: ___________________________ Date: _______________
Printed name:
WITNESS
Signature: ___________________________ Date: _______________
Printed name:
This document is a self-help template and does not constitute legal advice. Independent legal advice from a licensed lawyer in Ontario is recommended before reliance.
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