Transcription of Sample of Statutory Declaration [Statutory Declaration ...
1 Sample of Statutory Declaration [ Statutory Declaration should be type using Company letterhead] Statutory Declaration I _____ (name of applicant) (NRIC No. _____) of (address) solemnly and sincerely declare the following: 1. That I am _____ (position in Company) in _____(Company name and address) and am duly authorized to affirm this Declaration on behalf of the Company; 2. I make this Declaration in full knowledge and awareness of the Government of Malaysia s reliance on this Declaration as an inducement or basis to endorse/certify on document(s) presented by our Company; 3. I undertake and agree to fully indemnify the Government of Malaysia in full from and against all consequences, liabilities, actions, suits, proceedings, damages, costs, claims, demands, expenses, or losses whatsoever which may taken or made against the Government of Malaysia or incurred or become payable by the Government of Malaysia by reason of or on account of or arising out of its issuing, endorsing or certifying the aforesaid documents; 4.
2 I am fully aware that it is a criminal offence to induce the Government of Malaysia to endorse on our documents on the basis of a false Declaration ; 5. I am also aware that the penal consequences for a false Declaration in respect of the above, I may be punishable under Penal Code [Act 574] read together with Section 3 of the Statutory Declaration Act 1960 [Act 13] or any other applicable law in Malaysia. And I make this solemn Declaration conscientiously believing the same to be true and by virtue of the provisions of the Statutory Declaration Act 1960 [Act 13]. Subscribed and solemnly ) declared by the abovenamed ) at _____ ).
3 In the state of _____ ) Signature of applicant on this day of 20 ) (Director/ Proprietor/ Partner) Before me, .. COMMISSIONER FOR OATHS
![FIRST SCHEDULE 162/88, 90/99,318/12] - …](/cache/preview/5/9/4/f/4/0/6/1/thumb-594f4061e61fbd66812936804bf1f548.jpg)
