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Solemn Declaration - previous version

Form number: 1076

This form is to be used for applications relating to the September 1, 2016–August 31, 2017 award year.

You must fill out this form if you need to clarify your situation or are unable to provide one or more of the required documents.

This form will not be considered valid unless it has been signed by a Commissioner for Oaths.

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Digital transmission

Once you print and fill out the form, sign it yourself and have it signed by a Commissioner for Oaths, then scan it. Use our Online Services to upload the completed form.

Other way to submit your document

Mail

If you are unable to submit this form digitally you can mail it to us. Print the form, fill it out, sign it yourself, have it signed by a Commissioner for Oaths and mail it to the address shown on the form itself.

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