Statutory Declaration

I/We: John Smith

Of: 1 Pitt St Sydney
in the State of New South Wales, do solemnly and sincerely declare as follows:
That my credit card with ABC Bank Ltd has been closed.
And I/we make this solemn declaration conscientiously believing the same to be true and by virtue
of the provisions of the Oaths Act, 1900 (as amended).
Subscribed and declared at Sydney NSW
This 1st day of January 2018.

(SIGN)
John Smith
Before me:
(SIGN)
Name: (Name of JP)
Justice of the Peace #: 123456

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