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Statutory Declaration – Affiliate

Statutory Declaration - Affiliate

  • I do solemnly and sincerely declare that I have lost the RSL Affiliate Badge No:
  • That the circumstances in which the said loss occurred are as under:
  • THAT to the best of my knowledge and belief the said Badge is not in the hands of any other person on my behalf or with my consent. AND I make this solemn declaration by virtue of Section 106 of the Evidence Act of 1906, conscientiously believing the statement contained therein to be true in every particular.
  • Note: Cost of replacement is $5.00 when supplies available. This amount must be forwarded with this Statutory Declaration; otherwise a replacement badge will not be issued. Any person who wilfully makes a false statement in a Statutory Declaration is guilty of an indictable offence, and is liable to imprisonment, with or without hard labour, for four years.
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