Statutory Declaration Template UK – Free Example + Tailored PDF

The 1835 Act fixes the opening and closing, and the witness completes the jurat. Deviation risks rejection: HM Passport Office’s caseworker guidance says a change of name declaration without the Act’s legal statement must not be accepted. In order, a statutory declaration has:

1. A title, such as “Statutory declaration”.
2. The opening: your full name, address and occupation, then “do solemnly and sincerely declare that”.
3. Numbered paragraphs of fact, one point each.
4. The closing invoking the Statutory Declarations Act 1835.
5. Your signature, added only in front of the witness.
6. The jurat: where and when it was declared, and the witness’s signature, name and capacity.

The free example below follows that order: sign on the “Signed” line, above the jurat, only when you are in front of your witness. Copy it, replace the bracketed text and add your own numbered facts.

STATUTORY DECLARATION

I [your full name] of [your full address], [your occupation], do solemnly and sincerely declare that:

1. [First statement of fact.]
2. [Second statement of fact.]
3. [Further statements as needed.]

and I make this solemn declaration conscientiously believing the same to be true, and by virtue of the provisions of the Statutory Declarations Act 1835.

Signature of declarant: ______________________________ (sign in the name given above, in front of your witness)

DECLARED at ______________ this ______ day of ______________ 20____

Before me: ______________ (signature) Name: ______________ Capacity: Solicitor / Commissioner for Oaths / Notary Public / JP

WARNING: In England and Wales, knowingly and wilfully making a statutory declaration false in a material particular is an offence under section 5 of the Perjury Act 1911, punishable by up to two years’ imprisonment or a fine, or both. Other jurisdictions have their own laws. Do not sign this document until you are in front of your witness.

From the schedule to the Statutory Declarations Act 1835. Section 20 says declarations under the Act are to be in the form in that schedule, which begins “I A.B. do solemnly and sincerely declare” and ends by stating that you make the declaration “conscientiously believing the same to be true” under the Act. Where the schedule says to insert the title of the Act, current declarations name the Statutory Declarations Act 1835.

HM Passport Office staff must accept a change of name declaration that includes this legal statement and is signed in the new name. They must not accept one without the statement, or one signed in the old name only. That is why a template should keep the opening and closing word for word and change only the facts.

State facts you know to be true, in the order they happened, with names and dates exactly as they appear on the documents. Knowingly making a false statement in a statutory declaration is an offence punishable by up to two years’ imprisonment under section 5 of the Perjury Act 1911 in England and Wales. Examples of what each type of declaration usually covers:

• Name history: HM Passport Office asks for a declaration covering every name you have used, when you used each one and, if known, the circumstances of each change, when you cannot show the link between your old and new names.
• Two names, one person: each document, the name shown on it, a statement that both names refer to you, and how the difference arose. See the “one and the same person” declaration.
• Lost document: what the document was, its reference if known, when and how it was lost, the searches you made and what you will do if it turns up. See the lost document declaration.

Keep each paragraph to one fact. If the recipient has given you a list of points to cover, follow it in the same order.

Refer to each supporting document in the paragraph where it is relevant and give it a letter, for example “a copy of my passport, marked A”. The person taking your declaration marks each exhibit at the appointment. In England and Wales, the Commissioners for Oaths (Fees) Order 1993 allows £2 for each exhibit that has to be marked, on top of £5 per person making the declaration. Ask the recipient whether it wants copies, certified copies or originals before you mark anything; our generator adds an exhibit cover page for each document you list.

The witness completes it at the appointment. In England and Wales, section 183(4) of the Legal Services Act 2007 requires an authorised person taking an oath or declaration to state the place and the date in the jurat. The witness adds their signature, name and capacity, such as solicitor, Commissioner for Oaths, notary public or Justice of the Peace. Court form PE3 also says it will not be accepted without the witness’s full postal address. Leave the whole section blank when you print the document.

Not on your own. Form PE3 says any amendment must be re-witnessed. HM Land Registry says it may return a statement of truth or statutory declaration with minor or clerical errors so that the declarant can initial and date the amendments, but may reject an application where the errors are more significant. Read the draft aloud before the appointment, check every name and date against the documents, and never alter a witnessed date or reuse a signature page with a different version.

Yes. The 1835 Act applies across the UK, but who can witness differs:

Scottish JPs do not compose or supply forms, so take a completed, unsigned declaration with you. See who can witness a statutory declaration for the full list and overseas rules.