[{"id":"1e89d364-475a-479d-946a-6d854c3a2af4","order":1,"text":"CANADA","fontSize":"12","textAlign":"center","bold":true,"underline":false,"marginBottom":"5","cflou":false,"active":true},{"id":"f6684296-166c-4347-9cc0-6287a58166e2","order":2,"text":"IN THE MATTER OF the loss or destruction of a document","fontSize":"12","textAlign":"center","bold":false,"underline":false,"marginBottom":"25","cflou":false,"active":true},{"id":"a28ea987-c4a5-4b21-9657-29da68dd7672","order":3,"text":"STATUTORY DECLARATION","fontSize":"20","textAlign":"center","bold":true,"underline":false,"marginBottom":"5","cflou":false,"active":true},{"id":"babce330-2e25-4427-9405-a333d9b3df2b","order":4,"text":"(Made pursuant to section 41 of the Canada Evidence Act, R.S.C. 1985, c. C-5, and to the corresponding provisions of the evidence legislation of the province or territory named below)","fontSize":"11","textAlign":"center","bold":false,"underline":false,"marginBottom":"30","cflou":false,"active":true},{"id":"95a888d6-d982-4ead-b7d8-cfc881e6d96b","order":5,"text":"I, [Full legal name], of [Street address], in the City or Town of [City or town], in the Province of Ontario, postal code [Postal code], [Occupation], DO SOLEMNLY DECLARE AS FOLLOWS:","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"20","cflou":false,"active":true},{"id":"387c43ed-b139-42ca-8df6-66005d410b89","order":6,"text":"1. IDENTITY OF THE DECLARANT","fontSize":"16","textAlign":"left","bold":true,"underline":false,"marginBottom":"10","cflou":false,"active":true,"marginTop":"20","sectionNum":"S01"},{"id":"77bedb31-2752-477f-9ee4-7236fc6f9b3c","order":7,"text":"I am the declarant named above. I was born on [Date of birth] at [Place of birth]. I am of the full age of majority, of sound mind, and competent in all respects to make this declaration.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"0aa82ffb-5e86-4ffc-9195-0669190f5ef4","order":8,"text":"I have satisfied the officer before whom this declaration is made as to my identity by producing a valid Canadian passport.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"e72baf9d-8cdd-4ed0-9be8-4981afc8ce8f","order":9,"text":"I make this declaration in my own name and on my own behalf.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true,"displayConditions":[{"field":"1ae48847-3522-4b8b-8830-b8592c7c7d75","value":"own","type":"add","operator":"="}]},{"id":"f13e72c2-a28d-4cb7-93a6-e38d36ba77cc","order":10,"text":"I make this declaration as the parent or lawful guardian of [Full legal name of the person you represent], born on [Date of birth of the minor child], a minor child of whom I have the care and control, and I am authorized to make this declaration on that child's behalf.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true,"displayConditions":[{"field":"1ae48847-3522-4b8b-8830-b8592c7c7d75","value":"minor","type":"add","operator":"="}]},{"id":"842e6ea3-72e5-4db7-90a8-21e65bc94a40","order":11,"text":"I make this declaration as the attorney of [Full legal name of the person you represent] under a power of attorney dated [Date of the power of attorney], which remains in full force and effect and has not, to my knowledge, been revoked, suspended or terminated.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true,"displayConditions":[{"field":"1ae48847-3522-4b8b-8830-b8592c7c7d75","value":"attorney","type":"add","operator":"="}]},{"id":"768c661f-935a-423b-9e16-2409345c839b","order":12,"text":"Where I make this declaration in a representative capacity, any reference in it to my holding, possession, custody or loss of a document, or to my own circumstances, is to be read as a reference to the holding, possession, custody or loss by, or to the circumstances of, the person on whose behalf I make it.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true,"displayConditions":[{"field":"1ae48847-3522-4b8b-8830-b8592c7c7d75","value":"minor","type":"add","operator":"="},{"field":"1ae48847-3522-4b8b-8830-b8592c7c7d75","value":"attorney","type":"add","operator":"="}]},{"id":"50edf9a7-aab4-4881-9501-35451cb16628","order":13,"text":"2. BASIS OF KNOWLEDGE AND ABSENCE OF CONSTRAINT","fontSize":"16","textAlign":"left","bold":true,"underline":false,"marginBottom":"10","cflou":false,"active":true,"marginTop":"20","sectionNum":"S02"},{"id":"de88e60f-1a4e-4a7d-a8ae-018f92e04fab","order":14,"text":"The facts declared to below are within my personal knowledge, except where otherwise stated. Where a fact is stated to be on information and belief, I have identified the source of that information and I believe that fact to be true.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"2d9f6ab4-e07b-4585-bf17-59721c4a727e","order":15,"text":"I make this declaration freely and voluntarily, without coercion, duress, threat, promise or undue influence from any person, and no benefit or advantage has been offered to me in exchange for making it.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"f4669f09-f244-420a-b564-5e3ec5a65c8c","order":16,"text":"I am able and willing to attend before any competent authority, board or tribunal and to give evidence to the same effect if I am called upon to do so.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"06c691da-2b58-4e2c-b776-9a334349dce7","order":17,"text":"3. PURPOSE AND RECIPIENT OF THIS DECLARATION","fontSize":"16","textAlign":"left","bold":true,"underline":false,"marginBottom":"10","cflou":false,"active":true,"marginTop":"20","sectionNum":"S03"},{"id":"02eb6b29-10cb-46cc-a0c8-04768b4ad546","order":18,"text":"This declaration is made in relation to the loss or destruction of a document.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"cc511e28-eec4-4b94-9b0e-af9061876cb8","order":19,"text":"It is provided to [Person, institution or authority receiving this declaration], and I understand and intend that the recipient may rely upon it as evidence of the facts declared to.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"07da1471-8f6b-455b-81ff-88aba24ff7a7","order":20,"text":"I make this declaration for that purpose alone, and for no improper or collateral purpose. I am aware that the recipient may verify the facts declared to and may require further evidence in support of them.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"ac70a2ab-ed29-4853-8a6f-f7376214b684","order":21,"text":"4. STATEMENT OF FACTS","fontSize":"16","textAlign":"left","bold":true,"underline":false,"marginBottom":"10","cflou":false,"active":true,"marginTop":"20","sectionNum":"S04"},{"id":"afb49786-01dc-49fd-b14d-f0016a8009c2","order":22,"text":"The facts to which I solemnly declare are the following.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"f1dd08b3-162a-414f-9e01-57211efdbc05","order":23,"text":"I was at all material times the lawful holder of [Description of the document], issued to me by [Issuing authority] on or about [Date of issue] and bearing number [Document or serial number].","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true,"displayConditions":[{"field":"56bbe28b-1cb1-497c-b9b6-686da2929464","value":"the loss or destruction of a document","type":"add","operator":"="}]},{"id":"053cc724-0686-4499-aa86-efda1209437c","order":24,"text":"On or about [Date of the loss], at [Place of the loss], the said document was lost.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true,"displayConditions":[{"field":"56bbe28b-1cb1-497c-b9b6-686da2929464","value":"the loss or destruction of a document","type":"add","operator":"="}]},{"id":"dcbe46c1-77d7-49b3-9f84-8c133535f388","order":25,"text":"The circumstances in which this occurred are the following: [Circumstances of the loss]","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true,"displayConditions":[{"field":"56bbe28b-1cb1-497c-b9b6-686da2929464","value":"the loss or destruction of a document","type":"add","operator":"="}]},{"id":"1b7bb4f6-d27b-4e0e-b108-b60fa3c3e0fa","order":26,"text":"I have since made such search and inquiry for the said document as the circumstances permit. In particular, I have taken the following steps: [Steps taken to find the document]","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true,"displayConditions":[{"field":"56bbe28b-1cb1-497c-b9b6-686da2929464","value":"the loss or destruction of a document","type":"add","operator":"="}]},{"id":"1f81378a-db72-4509-94dc-3a1c0dda208f","order":27,"text":"Despite that search and inquiry, I have been unable to find or recover the said document, and I verily believe it to be irretrievably lost, destroyed or otherwise beyond my recovery.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true,"displayConditions":[{"field":"56bbe28b-1cb1-497c-b9b6-686da2929464","value":"the loss or destruction of a document","type":"add","operator":"="}]},{"id":"09dbcd71-5144-4598-8617-6c8cc3578146","order":28,"text":"I have not sold, assigned, pledged, transferred, endorsed, deposited by way of security or otherwise disposed of the said document, and no person has any right, title or interest in it by, from or under me.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true,"displayConditions":[{"field":"56bbe28b-1cb1-497c-b9b6-686da2929464","value":"the loss or destruction of a document","type":"add","operator":"="}]},{"id":"ef9480de-e9b7-421b-a5a5-59e263929511","order":29,"text":"To the best of my knowledge and belief, the said document is not in the possession or under the control of any other person, and it has not been used by any person for any unlawful purpose.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true,"displayConditions":[{"field":"56bbe28b-1cb1-497c-b9b6-686da2929464","value":"the loss or destruction of a document","type":"add","operator":"="}]},{"id":"9a9d8944-287d-4a51-b5af-2a8a492635f3","order":30,"text":"The loss or theft was reported to [Police service] on [Date of the report], under report or file number [Report or file number].","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true,"displayConditions":[{"field":"fc03f8f3-aae4-4b85-ae92-d9cda5f2cf25","value":"yes","type":"add","operator":"="},{"field":"56bbe28b-1cb1-497c-b9b6-686da2929464","value":"the identity of the declarant","type":"remove","operator":"="},{"field":"56bbe28b-1cb1-497c-b9b6-686da2929464","value":"a common-law relationship","type":"remove","operator":"="},{"field":"56bbe28b-1cb1-497c-b9b6-686da2929464","value":"the facts declared to below","type":"remove","operator":"="}]},{"id":"42dd9484-035f-4be2-ab32-1230801cf8a0","order":31,"text":"I am aware that the issuing authority may cancel the said document, that it will thereafter be invalid for travel, identification or any other purpose, and that it must not be used by any person if it is subsequently found.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true,"displayConditions":[{"field":"56bbe28b-1cb1-497c-b9b6-686da2929464","value":"the loss or destruction of a document","type":"add","operator":"="}]},{"id":"8c2daab5-f6ae-453d-8e57-0ed6ad1ad40e","order":32,"text":"I have made no previous application for a replacement of the said document in respect of the same loss, and I am not aware of any circumstance that would render this declaration inaccurate or incomplete.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true,"displayConditions":[{"field":"56bbe28b-1cb1-497c-b9b6-686da2929464","value":"the loss or destruction of a document","type":"add","operator":"="}]},{"id":"ed3c8c6b-46fa-4941-b826-8247445d46ac","order":33,"text":"My full legal name is [Full legal name]. My name appears as [Name as shown on the first document] on [First document], and as [Name as shown on the second document] on [Second document].","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true,"displayConditions":[{"field":"56bbe28b-1cb1-497c-b9b6-686da2929464","value":"the identity of the declarant","type":"add","operator":"="}]},{"id":"69372757-3b8e-469c-acd8-c4bbd5e012e1","order":34,"text":"The names referred to above designate one and the same person, namely myself. The difference between them arises from a clerical or spelling error made when one of the documents was issued.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true,"displayConditions":[{"field":"56bbe28b-1cb1-497c-b9b6-686da2929464","value":"the identity of the declarant","type":"add","operator":"="}]},{"id":"6c73bbaf-be06-45d9-bc29-5c564c6abf8f","order":35,"text":"I have also been known by, or my name has also been recorded as, the following: [Other names or spellings]","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true,"displayConditions":[{"field":"ffe3995f-97ab-4864-aaf0-ff029f26f4b9","value":"have used or been known only by the names and spellings set out above","type":"add","operator":"="},{"field":"56bbe28b-1cb1-497c-b9b6-686da2929464","value":"the loss or destruction of a document","type":"remove","operator":"="},{"field":"56bbe28b-1cb1-497c-b9b6-686da2929464","value":"a common-law relationship","type":"remove","operator":"="},{"field":"56bbe28b-1cb1-497c-b9b6-686da2929464","value":"the facts declared to below","type":"remove","operator":"="}]},{"id":"ce4f19c7-566f-4541-b396-117526067caa","order":36,"text":"I have never used or been known by any other name or spelling, and I have no other identity or record of civil status.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true,"displayConditions":[{"field":"56bbe28b-1cb1-497c-b9b6-686da2929464","value":"the identity of the declarant","type":"add","operator":"="}]},{"id":"45914815-1210-4ec6-b9dc-055e2f472d4d","order":37,"text":"My true and correct name for all purposes is the name first set out in this declaration, and every other name or spelling referred to above designates that same person.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true,"displayConditions":[{"field":"56bbe28b-1cb1-497c-b9b6-686da2929464","value":"the identity of the declarant","type":"add","operator":"="}]},{"id":"6e32755c-7fda-4658-b6c8-b8124ef8fc1c","order":38,"text":"I make this declaration to establish that the documents referred to above relate to one and the same person, and not for the purpose of concealing my identity or of obtaining any benefit, status or entitlement to which I am not lawfully entitled.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true,"displayConditions":[{"field":"56bbe28b-1cb1-497c-b9b6-686da2929464","value":"the identity of the declarant","type":"add","operator":"="}]},{"id":"04777079-398f-4421-8b31-42685bb9c143","order":39,"text":"I have been living with [Full legal name of your partner], born on [Date of birth of your partner], in a conjugal relationship.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true,"displayConditions":[{"field":"56bbe28b-1cb1-497c-b9b6-686da2929464","value":"a common-law relationship","type":"add","operator":"="}]},{"id":"31f252df-43c0-4780-8c14-b4dd49180196","order":40,"text":"We began to cohabit in a conjugal relationship on or about [Date cohabitation began], and we have lived together continuously since that date.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true,"displayConditions":[{"field":"56bbe28b-1cb1-497c-b9b6-686da2929464","value":"a common-law relationship","type":"add","operator":"="}]},{"id":"4f1f25de-60e1-4fa4-87e9-a57d7172ffd7","order":41,"text":"Our common residence is [Address of your common residence].","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true,"displayConditions":[{"field":"56bbe28b-1cb1-497c-b9b6-686da2929464","value":"a common-law relationship","type":"add","operator":"="}]},{"id":"68ba1ca8-5642-440d-afed-d41f96ab1c3e","order":42,"text":"Our cohabitation has been continuous since that date, and any absence from the common residence has been temporary and attributable to employment, study, health, travel or family obligation.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true,"displayConditions":[{"field":"56bbe28b-1cb1-497c-b9b6-686da2929464","value":"a common-law relationship","type":"add","operator":"="}]},{"id":"bb024120-a47c-4128-b2a1-e24a68940374","order":43,"text":"We are not married to one another. Neither of us is married to any other person.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true,"displayConditions":[{"field":"56bbe28b-1cb1-497c-b9b6-686da2929464","value":"a common-law relationship","type":"add","operator":"="}]},{"id":"d762ba8e-d292-4b27-b011-96b172451453","order":44,"text":"Neither of us is related to the other within any degree prohibited by law, each of us is of the full age of majority, and each of us was capable of consenting to our relationship when it began.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true,"displayConditions":[{"field":"56bbe28b-1cb1-497c-b9b6-686da2929464","value":"a common-law relationship","type":"add","operator":"="}]},{"id":"96bf2532-45c6-41c5-bce1-11a7ae593e0d","order":45,"text":"Our relationship is genuine, continuing and exclusive. We present ourselves publicly as partners and share the responsibilities and the expenses of a common household.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true,"displayConditions":[{"field":"56bbe28b-1cb1-497c-b9b6-686da2929464","value":"a common-law relationship","type":"add","operator":"="}]},{"id":"51ca6ca0-5b2b-4b80-99f1-96df3bd7c0e2","order":46,"text":"We share our lives in particular in the following ways: [Joint accounts, joint lease or title, beneficiary designations, shared expenses]","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true,"displayConditions":[{"field":"56bbe28b-1cb1-497c-b9b6-686da2929464","value":"a common-law relationship","type":"add","operator":"="}]},{"id":"ae3537b8-13e9-4ac0-8573-55eaf47b8cb8","order":47,"text":"We have no children of our relationship.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true,"displayConditions":[{"field":"56bbe28b-1cb1-497c-b9b6-686da2929464","value":"a common-law relationship","type":"add","operator":"="}]},{"id":"68d67736-fcd1-4810-a0eb-f8471d31666c","order":48,"text":"Our child or children are the following: [Names and dates of birth of the children]","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true,"displayConditions":[{"field":"d52eb44e-bf51-4cc5-a206-0b7d8decc693","value":"are the parents of a child or children of our relationship","type":"add","operator":"="},{"field":"56bbe28b-1cb1-497c-b9b6-686da2929464","value":"the loss or destruction of a document","type":"remove","operator":"="},{"field":"56bbe28b-1cb1-497c-b9b6-686da2929464","value":"the identity of the declarant","type":"remove","operator":"="},{"field":"56bbe28b-1cb1-497c-b9b6-686da2929464","value":"the facts declared to below","type":"remove","operator":"="}]},{"id":"bca444f2-6522-44d8-bca3-e311250f7be6","order":49,"text":"Our relationship was not entered into for the purpose of acquiring any status, benefit, privilege or advantage under any statute or program, and I am aware that it may be verified by the recipient of this declaration.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true,"displayConditions":[{"field":"56bbe28b-1cb1-497c-b9b6-686da2929464","value":"a common-law relationship","type":"add","operator":"="}]},{"id":"21c0911f-6e79-4062-aa2f-6b8dfa0c5451","order":50,"text":"[Set out the facts declared to]","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true,"displayConditions":[{"field":"56bbe28b-1cb1-497c-b9b6-686da2929464","value":"the facts declared to below","type":"add","operator":"="}]},{"id":"afbd9aef-1724-40df-972c-260836e90f74","order":51,"text":"The facts set out above are true, complete and accurate, and I have not omitted any fact that would render them misleading or incomplete.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true,"displayConditions":[{"field":"56bbe28b-1cb1-497c-b9b6-686da2929464","value":"the facts declared to below","type":"add","operator":"="}]},{"id":"cb9ab5b0-3185-4662-b97b-a0638c727783","order":52,"text":"I make this declaration in support of the purpose described above, and I am able to produce further evidence of the facts declared to if the recipient requires it.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true,"displayConditions":[{"field":"56bbe28b-1cb1-497c-b9b6-686da2929464","value":"the facts declared to below","type":"add","operator":"="}]},{"id":"30bcaca7-7567-4cb4-ae53-4224eb34be10","order":53,"text":"5. UNDERTAKING AND INDEMNITY","fontSize":"16","textAlign":"left","bold":true,"underline":false,"marginBottom":"10","cflou":false,"active":true,"marginTop":"20","displayConditions":[{"field":"56bbe28b-1cb1-497c-b9b6-686da2929464","value":"the loss or destruction of a document","type":"add","operator":"="}],"sectionNum":"S05"},{"id":"df068946-45a2-48a4-8f3a-e6ed3e9a3a11","order":54,"text":"If the said document is at any time found or recovered by me, or otherwise comes into my possession or under my control, I undertake to deliver it up forthwith to [Issuing authority] and to notify [Person, institution or authority receiving this declaration] in writing without delay.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true,"displayConditions":[{"field":"56bbe28b-1cb1-497c-b9b6-686da2929464","value":"the loss or destruction of a document","type":"add","operator":"="}]},{"id":"2efab64a-4e00-47b2-96e3-16f622ed36e8","order":55,"text":"I undertake not to use, and not to permit any other person to use, the said document for any purpose whatsoever, whether before or after a replacement is issued.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true,"displayConditions":[{"field":"56bbe28b-1cb1-497c-b9b6-686da2929464","value":"the loss or destruction of a document","type":"add","operator":"="}]},{"id":"d4af0450-ab46-4bdf-a730-51cd4c1356a2","order":56,"text":"In consideration of the issuance of a replacement document, I agree to indemnify and save harmless [Issuing authority], together with its officers, employees and agents, from and against all claims, demands, actions, losses, costs and expenses of any nature arising directly or indirectly from the issuance of the replacement or from any use made of the document declared to be lost.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true,"displayConditions":[{"field":"56bbe28b-1cb1-497c-b9b6-686da2929464","value":"the loss or destruction of a document","type":"add","operator":"="}]},{"id":"6d2d68b5-be33-4e88-954c-12f3b5d1e954","order":57,"text":"This undertaking and indemnity binds me and my heirs, executors, administrators and personal representatives, and continues in force notwithstanding the issuance of the replacement document.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true,"displayConditions":[{"field":"56bbe28b-1cb1-497c-b9b6-686da2929464","value":"the loss or destruction of a document","type":"add","operator":"="}]},{"id":"bacee4ce-f694-439a-b5bf-2e5a7aa81448","order":58,"text":"6. SUPPORTING DOCUMENTS AND EXHIBITS","fontSize":"16","textAlign":"left","bold":true,"underline":false,"marginBottom":"10","cflou":false,"active":true,"marginTop":"20","displayConditions":[{"field":"2d177c47-be2d-4658-9cb9-a2953cb12186","value":"yes","type":"add","operator":"="}],"sectionNum":"S06"},{"id":"1bd6eb01-1d68-4cba-befd-cd3f8e7fe81c","order":59,"text":"The following documents are attached to this declaration and form part of it: [List of the documents attached]","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true,"displayConditions":[{"field":"2d177c47-be2d-4658-9cb9-a2953cb12186","value":"yes","type":"add","operator":"="}]},{"id":"fb1d64fb-38a9-40a8-86f8-34f0af17df03","order":60,"text":"Each document so attached has been produced to, marked and initialled by the officer before whom this declaration is made, and each is either an original or a true copy of the document it purports to be.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true,"displayConditions":[{"field":"2d177c47-be2d-4658-9cb9-a2953cb12186","value":"yes","type":"add","operator":"="}]},{"id":"bd09ab62-77f8-4063-8228-d56605ef26f8","order":61,"text":"7. 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I fully understood its contents and confirmed them to be true before signing it.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true,"displayConditions":[{"field":"333aa87e-c449-4504-91c0-4eb1fcceab2e","value":"yes","type":"add","operator":"="}]},{"id":"d2e3bd87-dabf-4e32-8b6f-ef356f2d1db3","order":64,"text":"8. USE OF THIS DECLARATION AND PERSONAL INFORMATION","fontSize":"16","textAlign":"left","bold":true,"underline":false,"marginBottom":"10","cflou":false,"active":true,"marginTop":"20","sectionNum":"S08"},{"id":"cebcf963-6991-4368-b596-a821aaa78966","order":65,"text":"I consent to the collection, use and disclosure by the recipient of the personal information contained in this declaration, and in any document attached to it, for the purpose described above and for no other purpose, in accordance with applicable federal and provincial privacy legislation.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"146771bb-105e-4449-9181-8b39e327389a","order":66,"text":"I undertake to inform the recipient in writing, without delay, if I become aware that any fact declared to in this declaration has ceased to be accurate or was inaccurate when this declaration was made.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"bcb84ac9-417e-4de8-a43d-88df64246fb5","order":67,"text":"I authorize the recipient to verify the facts declared to with any person, institution or authority named in this declaration, and to obtain from them any confirmation reasonably required for that purpose.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"cef7bb25-4d2c-4b78-9765-57ceb228a854","order":68,"text":"This declaration may be produced and relied upon in any application, proceeding or process relating to the purpose described above, and it is made without prejudice to any other statement or document made or given by me.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"79272ab9-20fb-4a07-a0cd-e43449069a60","order":69,"text":"This declaration is made under, and is to be interpreted in accordance with, the law of the Province of Ontario and the laws of Canada applicable therein.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"3d4b59ee-ef73-461a-8dc9-9d0b2289a5bc","order":70,"text":"9. CONSEQUENCES OF A FALSE DECLARATION","fontSize":"16","textAlign":"left","bold":true,"underline":false,"marginBottom":"10","cflou":false,"active":true,"marginTop":"20","sectionNum":"S09"},{"id":"a3f3e839-d57a-47e2-96c2-ac83accdc33c","order":71,"text":"I understand that this solemn declaration has the same force and effect as if made under oath, and that a person who, with intent to mislead, knowingly makes a false statement in a solemn declaration before a person authorized by law to receive it commits perjury under section 131 of the Criminal Code and is liable, under section 132 of that Act, to imprisonment for a term of not more than fourteen years.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"d36400bc-38e7-4e48-a77c-5d563afcb1f7","order":72,"text":"I further understand that a declaration found to be false or misleading may result in the refusal, suspension, cancellation or revocation of any document, benefit, status or entitlement obtained or sought in reliance upon it, and may give rise to civil liability.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"345ed690-5aeb-41ff-9fdb-b4ba6f3dca2e","order":73,"text":"10. EXECUTION OF THIS DECLARATION","fontSize":"16","textAlign":"left","bold":true,"underline":false,"marginBottom":"10","cflou":false,"active":true,"marginTop":"20","sectionNum":"S10"},{"id":"96715f7d-6fe6-43d2-bd1b-815cfa92f68a","order":74,"text":"I have read this declaration in its entirety, or it has been read and explained to me, and I understand each of its provisions.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"974d3e6c-474a-4e73-bf98-e1d0b565aecd","order":75,"text":"I have initialled each page of this declaration. No erasure, interlineation or other alteration has been made to it, other than one initialled by me and by the officer before whom it is made.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"77ca78f8-3440-4f77-bd37-b24646e86e7d","order":76,"text":"I sign this declaration in the physical presence of the officer named below, having first satisfied myself that the officer is authorized to take it.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true,"displayConditions":[{"field":"716fbf7a-2a3f-491d-90ab-5d90c45f86c6","value":"in person","type":"add","operator":"="}]},{"id":"9213f851-26cc-400f-9ca7-ae8c646f1b7c","order":77,"text":"I sign this declaration by two-way audiovisual communication technology, in accordance with the legislation of the province or territory named above that permits a declaration to be taken remotely. I was able to see, hear and speak with the officer in real time throughout, I displayed my identification to the officer during that communication, and the officer and I each signed a counterpart of this declaration bearing the same date.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true,"displayConditions":[{"field":"716fbf7a-2a3f-491d-90ab-5d90c45f86c6","value":"remote","type":"add","operator":"="}]},{"id":"d1092de2-f1f5-4bee-aedd-ed38a0e503ed","order":78,"text":"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.","fontSize":"14","textAlign":"left","bold":true,"underline":false,"marginBottom":"30","cflou":false,"active":true,"marginTop":"25"},{"id":"24c826ac-26f2-4e0f-8e45-92208ba1aeeb","order":79,"text":"DECLARED BEFORE ME at the City or Town of [City or town], in the Province of Ontario, on [Date of the 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for the Province of Ontario","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"5","cflou":false,"active":true},{"id":"1e6b86b3-9c09-452d-bc43-e13d502b0e23","order":85,"text":"Name of the officer (please print): ______________________________","fontSize":"12","textAlign":"left","bold":false,"underline":false,"marginBottom":"5","cflou":false,"active":true},{"id":"f11ad4ea-120c-40db-b4d4-bfca839c7a22","order":86,"text":"My appointment expires on: ______________________________","fontSize":"12","textAlign":"left","bold":false,"underline":false,"marginBottom":"30","cflou":false,"active":true,"displayConditions":[{"field":"6b6730bf-e26e-41c3-8250-e78466b9ff52","value":"A Commissioner for Taking Affidavits","type":"add","operator":"="},{"field":"6b6730bf-e26e-41c3-8250-e78466b9ff52","value":"A Commissioner for Oaths","type":"add","operator":"="}]},{"id":"baaa6267-9956-4577-84de-14c6592be787","order":87,"text":"INTERPRETER'S 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