STATUTORY DECLARATION - Landgate

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FORM B3 WESTERN AUSTRALIA TRANSFER OF LAND ACT 1893 OATHS, AFFIDAVITS AND STATUTORY DECLARATIONS ACT 2005 STATUTORY DECLARATIONI / WE (name, address and occupation of person(s) making the DECLARATION ) sincerely declare as follows - This DECLARATION is true and I / WE know that it is an offence to make a DECLARATION knowing that it is false in a material particular. This DECLARATION is made under the Oaths, Affidavits and STATUTORY Declarations Act 2005 at (place) ________________________________________ ____ on ______ day of __________________________ 20 ______ by - ________________________________________ _______ Signature of person(s) making the DECLARATION (sign in the space above) In the presence of - ___________________________________ Signature of authorised witness (sign in the space above) (Print the full name, address and qualification of authorised witness in the space above) INSTRUCTIONS 1.

A person who is registered under the . Architects Act 2004. Architect . 4. An Australian Consular Officer within the meaning of the . Consular Fees Act 1955. of the Commonwealth. Australian Consular Officer . 5. An Australian Diplomatic Officer within the meaning of the .

  Registered, Architect