Statutory declaration of marital status

STATUTORY DECLARATION
(Canada Evidence Act / Evidence Act, Ontario)

I, [full legal name], of the City of [city], in the Province of Ontario, DO SOLEMNLY DECLARE THAT:

1. My current marital status is [single / married / common-law / separated / divorced / widowed].
2. [If applicable] This status has been in effect since [date], being the date of my [marriage / separation / divorce / spouse’s death].
3. [Any further relevant facts, e.g. spouse’s name, place of marriage.]
4. I make this declaration for the purposes of [institution / purpose].

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.

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Signature of declarant                          Date

Declared before me at the City of [city], in the Province of Ontario, this [day] day of [month], [year].

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A Commissioner for Taking Affidavits in and for Ontario

Don't sign it yet. Bring the completed, unsigned document to your session — the commissioner watches you sign.