Commonwealth of Australia

STATUTORY DECLARATION
Statutory Declarations Act 1959
1 Insert the name,
address and
occupation of
person making
the declaration
I,
1
Deepa patha li!in" at #$11 re"ent street %itta"on" NS&, worin" full time as tru' (ri!er)
mae the followin" (e'laration un(er the Statutory Declarations Act 1959:
2 Set out matter
declared to in
numbered
paragraphs
# I am hol(in" *+, !isa su-'lass in Australia , passport no./E01*,*,1 , !isa "rant no./ +2*03124,#,30)
%5 D)O)6 is 1#$2+$10+,)
i want to sponsor m5 parents 7mr In(er8it patha9father:,%rs ;iran patha9mother: to !isit Australia for tourism)
In(er8it patha,passport no./ 9DO6./ :
iran patha,passport no./ <1,##**2 9DO6./1#$#$1041 :
Resi(ent of./house no./11$1#2 a=a( 'how -an"a
Distt
Nawanshahr,post'o(e 1**323
I here-5 un(ertae that i will -e responsi-le for the tra!ellin",foo(,a''ommo(ation,health an( all
other e>penses of m5 parents throu"hout the perio( of their sta5 in Australia)
Durin" their sta5 in Australia,the5 will resi(e with me at #$11 re"ent street %itta"on" #3,3 NS&)i
un(erstan( Australian LA&S an( re"ulations an( "i!e a "uarantee to Australian hi"h 'ommission
(elhi in(ia on -ehalf of m5 -parentsthat the5 willnot -rea'h an5 rules$re"ulation (urin" their sta5 in
Australia)
?lease issue them Australian !isitor !isa, i will -e !er5 thanfull to 5ou for this a't)
I un(erstan( that a person who intentionall5 maes a false statement in a statutor5 (e'laration is
"uilt5 of an offen'e un(er se'tion 11 of the Statutory Declarations Act 1959, an( I -elie!e that the
statements in this (e'laration are true in e!er5 parti'ular)
Signature of
person making
the declaration
1
! "lace
5 Day
# $onth and year
De'lare( at
*
on
3
of
4

6efore me,
% Signature of
person before
&hom the
declaration is
made 'see o(er)
,
* +ull name,
,ualification and
address of person
before &hom the
declaration is
made 'in printed
letters)
+
-ote 1 A person who intentionall5 maes a false statement in a statutor5 (e'laration is "uilt5 of an offen'e, the punishment for
whi'h is imprisonment for a term of * 5ears @ see se'tion 11 of the Statutory Declarations Act 1959)
-ote 2 Chapter # of the .riminal .ode applies to all offen'es a"ainst the Statutory Declarations Act 1959 @ see se'tion 3A of
the Statutory Declarations Act 1959)