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Appendix 2

Appendix 2

Statutory Declaration

A statutory declaration allows a person to make a legal declaration under oath and in the presence of a lawyer. They are commonly used when an individual needs to satisfy a legal requirement by affirming the truth of something.

Template

Statutory Declaration

I [NAME] of [ADDRESS]

do solemnly declare as follows
 

1. I am a full- time student at Queen Mary, University of London I commenced my course in September 20XX. I am making this declaration in support of my application to be assessed as an independent student due to the fact that I am irreconcilably estranged from my parents and have been so for a considerable amount of time.

2. These are the circumstances of my estrangement (Explain when you became estranged and the details of how you became estranged)

3. I do not have any documentation from a professional about these events as this was a private matter which we kept within the family.

4. I have not seen or spoken to my father since [date] and I have not seen or spoken to my mother since [date].

5. Summarise why you think the estrangement is irreconcilable (for example, “Because the estrangement from my parents is a permanent long-term situation, I believe this is irreconcilable”)

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

Declared by the above       )

Named                             )

Name of STUDENT           )

AT                                   )

                                       )

                                       )

                                       )

This               day of                       )

                                 2015             )

                                                                       Before Me
 

                                                                                                                 Solicitor/Commissioner for Oaths


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