Free Statutory Declaration Template

STATUTORY DECLARATION

Statutory Declarations Act 1835  ·  United Kingdom

DECLARANT

DECLARATION

I, Margaret Anne Williams, of 14 Victoria Road, Birmingham, B1 1BD, Retired Teacher, born on 1958-03-22, a British national, DO SOLEMNLY AND SINCERELY DECLARE AS FOLLOWS:

I am the person named Margaret Anne Williams and I reside at 14 Victoria Road, Birmingham B1 1BD. I have resided at this address continuously since 15 September 2018.

I lost my original birth certificate (issued by Birmingham Register Office, registration number BM-1958-03-2241) during a house move in approximately June 2020. Despite conducting a thorough search of my belongings and enquiring with the removal company (Shires Removals Ltd, based in Erdington), I have been unable to locate the original document.

I require a replacement birth certificate for the purpose of renewing my passport with HM Passport Office (application reference HMPO-2026-0031).

AND I make this solemn declaration conscientiously believing the same to be true, and by virtue of the provisions of the Statutory Declarations Act 1835.

I understand that wilfully making a statement in a statutory declaration which I know to be false or do not believe to be true is an offence under section 5 of the Perjury Act 1911, punishable on conviction on indictment with imprisonment for a term not exceeding two (2) years, or with a fine, or with both. I make this declaration conscientiously believing the same to be true.

The facts stated in this declaration are within my own knowledge, save where otherwise stated to be made on information and belief. Where any fact is stated to be on information or belief, I identify the source of that information, and I believe the fact stated to be true.

DECLARED at Birmingham this 2026-03-15 before me, David R. Henderson, of Henderson and Partners Solicitors, 3 Temple Row, Birmingham, B2 5LG (regulatory reference: SRA 123456), being a Solicitor of the Senior Courts of England and Wales empowered by section 81 of the Solicitors Act 1974 to administer oaths and statutory declarations. I confirm that the declarant appeared before me in person, that I am satisfied as to their identity, that they signed this declaration in my presence, and that they understood the nature of a statutory declaration and the consequences under the Perjury Act 1911 of making a false statement.

I, the person before whom this declaration is made, confirm that I have no interest in the subject matter of this declaration and that I am not a party to, nor a representative of any party to, any proceedings in which this declaration may be used. I have not advised the declarant on the contents of this declaration.

The declarant acknowledges the phased identity-verification regime introduced by the Economic Crime and Corporate Transparency Act 2023 ("ECCTA 2023") under new sections 1066A to 1066D of the Companies Act 2006 (inserted by ECCTA 2023 s.62), being commenced in stages during 2024-2026. Where this declaration is intended to be relied upon by Companies House (in respect of an application, registration, beneficial-ownership disclosure or persons-with-significant-control (PSC) confirmation), the declarant confirms that the identity-verification requirements (in force at the date of any such filing) have been or will be satisfied through an authorised corporate service provider (ACSP) or directly with the Registrar. In addition, the declarant's identity has been verified by the taker of this declaration in accordance with the Money Laundering, Terrorist Financing and Transfer of Funds (Information on the Payer) Regulations 2017 (SI 2017/692) regs 28-29 (customer due diligence). Identity documents relied upon: as recorded by the taker.

The declarant acknowledges that this declaration contains personal data within the meaning of the UK General Data Protection Regulation and the Data Protection Act 2018 (as amended by the Data (Use and Access) Act 2025 ("DUAA 2025")), the bulk of whose Part 5 data-protection amendments came into force on 5 February 2026 by the Data (Use and Access) Act 2025 (Commencement No. 6 and Transitional and Saving Provisions) Regulations 2026 (SI 2026/82); a new statutory complaints duty under s.164A DPA 2018 is in force from 19 June 2026.

(a) Lawful basis. Submission of this declaration to a public body (HM Passport Office, HMRC, DWP, Companies House, the courts) is processed by that body under UK GDPR Art 6(1)(c) (legal obligation) and / or Art 6(1)(e) (public task), with any Art 9 special-category processing on a corresponding Sch 1 DPA 2018 condition where applicable.

(b) Retention. The declarant acknowledges that public bodies retain statutory declarations in accordance with their published retention schedules and that the declarant's data-subject rights (access, rectification, erasure to the extent permitted by law) may be exercised against the recipient public body, subject to the new complaints route under s.164A DPA 2018.

(c) Confidentiality of the taker. The taker of this declaration shall hold any working copy and any identity-verification documents in accordance with the firm's data-retention policy and applicable SRA / regulator confidentiality duties.

The declarant declares, for the assistance of the recipient and (where this declaration is placed before a court or tribunal) for the Court, that the substantive content of the Statement of Facts above is the declarant's own personal recollection and knowledge.

Where any general-purpose AI tool, large-language-model assistant or document-drafting platform has been used in the preparation of this declaration, such use was limited to clerical assistance only (presenting standard clause templates, statutory cross-referencing, spelling and grammar checking). No factual statement above has been generated by an AI tool and adopted without the declarant's meaningful human review. Article 22(1) UK GDPR (right not to be subject to solely automated decisions producing legal or similarly significant effects) and the principles underlying the Courts and Tribunals Judiciary "Artificial Intelligence (AI) Guidance for Judicial Office Holders" (refreshed October 2025) and the Civil Justice Council's consultation "Use of AI in Preparing Court Documents" (opened 17 February 2026) — including the proposed mandatory AI-use declaration for trial witness statements under CPR PD 57AC and CPR Part 32 — have informed this declaration. The declarant confirms that no statutory citation, case citation or factual statement in this declaration is a product of AI hallucination; each has been verified against an authoritative source before signature.