Scribd
Upload
7 views1 page

Statutory Declaration for Diploma Reissue

This document is a statutory declaration for individuals applying to the University of Toronto for a new diploma due to the original being lost, destroyed, or not received. The declarant must provide their name, city, degree, and circumstances surrounding the diploma's status. The declaration includes an undertaking to return the replacement diploma if the original is found.

Uploaded by

overshee
Copyright
© All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
7 views1 page

Statutory Declaration for Diploma Reissue

This document is a statutory declaration for individuals applying to the University of Toronto for a new diploma due to the original being lost, destroyed, or not received. The declarant must provide their name, city, degree, and circumstances surrounding the diploma's status. The declaration includes an undertaking to return the replacement diploma if the original is found.

Uploaded by

overshee
Copyright
© All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

Statutory Declaration

PROVINCE OF ) IN THE MATTER OF AN APPLICATION TO THE


1. Does the county go here? afaik, only two
COUNTY OF provinces have counties, so that’s confusing. ) UNIVERSITY OF TORONTO FOR A NEW DIPLOMA.
TO WIT 2. what goes here?? )

1. I, , of
Name City/Municipality

3. what goes here??


in the, , do solemnly declare that:

I was admitted by the University of Toronto to the degree of:

, in the year of

2. The diploma was: Lost

Destroyed

Not Received

Due to the following circumstances:

I HEREBY UNDERTAKE, as a condition of the re-issue of a diploma, that if the original should be found at any time and restored to my
possession, I will forthwith return the replacement, to the Office of Convocation for cancellation.

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.

Signature of Declarant Declared before me in the city of ______________________


In the ____________________ of _____________________
Address of Declarant:
this ___________________ day of ____________________
20________

_______________________________________________
Signature of NOTARY PUBLIC
Telephone Number of Declarant:
( ) Affix Seal Here

Statutory Declaration, 12/09/2008

You might also like