The purpose of this form is for you to verify accuracy of the claims presented in your
Victorian Tourism Awards submission. As a condition of entry, this form must be
signed and witnessed.
Please bind a copy into your submission, behind front cover.
I _______________________________________________(print full name of declarant)
do solemnly declare that:
I am the proprietor/manager of ____________________________________
(insert name of the business/product entering the Tourism Awards);
The attached financial statements are in agreement with the accounts and
records of the business and the attached financial statements have been
prepared so as to present a true and fair view of the financial position of the
business, over the period specified in the statements.
The applicant warrants that all statements made within this submission are true.
and correct and are not misleading or deceptive. This applies to all statements.
made by the Applicant, whether before or after the submission of an application.
The content of my Tourism Awards submission has been prepared so as to
present a true and fair view of my business activities, during the qualifying
And I make this solemn declaration conscientiously believing the same to be true.
____________________________________________________(signature of declarant)
Taken and declared before me at ____________________ (insert location) in the State
of Victoria this _________(insert day of month) day of _______________(insert month)
____________________________________________________(signature of witness)
____________________________________________________(print name of witness)
____________________________________________________(title of witness)
(This document can be witnessed by a Justice of the Peace, a Member of the Police Force, a Principal in the
Teaching Service, a Councillor of the Municipality, a Medical Practitioner, a Dentist, a Veterinary Practitioner, a
Pharmacist, a Minister of Religion, a Certified or Chartered Accountant or the Manager of an Authorised