Statutory Declaration Example
Example document for Statutory Declaration. Use this as a reference when creating your own.
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Document: Statutory Declaration
Example Document
Last updated 7/27/2026
STATUTORY DECLARATION
I, JAMES SMITH of 42 George Street, Brisbane, in the State of Queensland, Builder, do solemnly and sincerely declare that:
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I am the sole proprietor of Smith Constructions, a building business located at 15 Industrial Avenue, Brisbane.
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On 12 May 2024, our work site at 100 Queen Street was broken into overnight.
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The following items were stolen from the locked storage container on site: a) One AEG 18V Brushless Hammer Drill, valued at $300. b) One DeWalt Table Saw, valued at $800. c) A set of concrete hand tools, valued at $450 total.
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The storage container was locked at 5:00pm on 11 May 2024 and the break-in was discovered by my employee at 6:30am on 12 May 2024.
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I have reported this matter to the Queensland Police Service and have been provided with event number EU123456.
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To the best of my knowledge, these items have not been recovered.
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I make this solemn declaration conscientiously believing the same to be true and by virtue of the Statutory Declarations Act 1959 (Cth).
DECLARATION DECLARED AT Brisbane in the State of Queensland
on the 15th day of May, 2024.
Before me,
......................................................... (Signed: SARAH JONES)
Justice of the Peace
Registration Number: 5498211
Address: 200 Queen Street, Brisbane
About this Example
Part of the Statutory Declaration document collection
Document Type
Statutory Declaration
A formal legal statement of facts used by Australian businesses and tradespeople to affirm the truth of matters for government departments, banks, and court proceedings.