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Sworn Affidavit Sample

This sworn statement is from a student petitioning their status as a non-Quebec resident for tuition purposes. The student declares under oath that they did not pursue full-time studies in Quebec between the given dates and acknowledges Concordia University can confirm this statement with the Ministry of Education. The student understands any false declaration carries legal consequences including tuition fees being charged at the higher Quebec resident rate.

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Bong Pasaway
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51 views1 page

Sworn Affidavit Sample

This sworn statement is from a student petitioning their status as a non-Quebec resident for tuition purposes. The student declares under oath that they did not pursue full-time studies in Quebec between the given dates and acknowledges Concordia University can confirm this statement with the Ministry of Education. The student understands any false declaration carries legal consequences including tuition fees being charged at the higher Quebec resident rate.

Uploaded by

Bong Pasaway
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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SWORN STATEMENT

PETITIONER: ____________________________________ Student ID: ____________________________


Last Name: ____________________________
ADDRESS: ______________________________________
Given Name: ___________________________

CITY/PROVINCE: _________________________________
Concordia University
POSTAL CODE: __________________________________ Enrolment Services, FB 900
(Provincial Residency)
HOME PHONE: (______)___________________________ 1455 Boulevard de Maisonneuve W.
Montréal, Québec
WORK PHONE: (______)___________________________
H3G 1M8

I, _________________________________________________ born on
Full name (given name, family name and married name if applicable)

_____________________ in __________________________________
Day, Month, Year Place of birth (city/town, country)

swear that from _____________________ to _____________________ ,


Day, Month, Year Day, Month, Year

I did not pursue full-time credit studies at an educational institution in Québec.

I am aware that by making this statement that I give Concordia University and
their agents the authority to confirm this statement to be true with the Ministère
de l’Éducation et de l’Enseignement supérieur (MEES).

I declare that the statement in this document is true, accurate and complete. I
understand that I am subject to the Canada Evidence Act by making this
declaration under oath. Any false declaration carries legal recourse and will
result in the non-Québec resident tuition fees being charged back to my
student account. __________
Initials

Witnessed in __________________________________ on
City/town, country

DATE : _________________________________

_______________________________________ ________________________________________
PETITIONER’S SIGNATURE COMMISSIONER OF OATHS

Enrolment Services
Concordia University
April 2019

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