How to Lodge a Statutory Declaration Form

You may need to lodge a Statutory Declaration form in the following situations:

  • Someone else’s services are already connected at a property you own or rent (preventing you from getting services connected to that address).
  • You need to take ownership of an account because the owner can no longer be contacted for any reason.
  • Any other situation that requires a legal statement from you.

If you’re ever unsure about what to do with your statutory declaration, please contact us.


  1. Download and/or print a copy of the form here. Single-sided or double-sided printing is acceptable. If you do not have access to a printer, you can get a Statutory Declaration form from your local Post Office. Alternatively, your local library may be able to help you print the form.
  2. Using a black or blue pen, fill out your Name, Address and Occupation, and then write your declaration in the space provided. If you are making a declaration as an authorised representative for a business, be sure to state this clearly. We've included some examples of written declarations below.

    Example 1: Making a declaration as an individual
    Example 2: Making a declaration as an authorised representative of a business

  3. Take your Statutory Declaration to be witnessed and signed by anyone from the list below, or listed in Note 2 on your form.
  4. Sign and date your form in front of your witness and then have them sign their name and title.
  5. Scan and email your form to, or fax it to 1300 785 632. Please include your reference number or iiNet username in your email subject or written on your fax. If you do not have access to a scanner, your local Post Office (and some newsagents) should offer fax services.
  6. A member of our Support Team will receive your declaration and then arrange contact with you to continue addressing your issue.
  • Architect
  • Australian Defence Force officer or a non-commissioned officer (as per Defence Force Discipline Act 1982) with at least 5 years of continuous service
  • Australian Postal Corporation worker with at least 5 years of continuous service
  • Bailiff
  • Bank officer with five or more years of continuous service
  • Building society officer with at least 5 years of continuous service
  • Chiropractor
  • Civil marriage celebrant
  • Commissioner for Affidavits
  • Commissioner for Declarations
  • Court clerk, Judge or Master
  • Credit union officer with at least 5 years of continuous service
  • Dentist
  • Financial adviser or planner
  • Justice of the Peace
  • Legal practitioner (lawyer)
  • Magistrate
  • Medical practitioner (doctor)
  • Member of Parliament
  • Midwife
  • Minister of religion registered under Division 1 of Part IV of the Marriage Act 1961
  • Notary Public
  • Nurse
  • Occupational therapist
  • Patent attorney
  • Pharmacist
  • Police officer
  • Sheriff
  • Sheriff's officer
  • Teacher working full-time at a school or tertiary education institution.
  • Veterinary surgeon

… or any other person listed on pages 2 and 3 of your Statutory Declaration Form.

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