STATUTORY DECLARATION Pursuant to the Statutory Declarations Act 1835 (United Kingdom) I, [Full Name of Declarant], of [Current Address, Town/City, Postcode, United Kingdom], Date of Birth: [DD/MM/YYYY], Nationality: Georgian, holder of Georgian Passport No. [Passport Number], DO SOLEMNLY AND SINCERELY DECLARE as follows: 1. [Set out clearly the factual statements, e.g., That I have resided continuously at the above address since DD/MM/YYYY.] 2. [E.g., That I am in a genuine and subsisting relationship with my partner [Partner Name]...] 3. [E.g., That all documents submitted in support of my application are authentic and true copies of the originals...] 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. DECLARED at [Town/City, e.g. London] this [Day] day of [Month], [Year] ____________________________________ Signature of Declarant Before me, [Solicitor Full Name], a Solicitor empowered to administer Oaths / Commissioner for Oaths: ____________________________________ Signature of Solicitor / Commissioner for Oaths Name & Address of Firm: [Law Firm Name, Address, Postcode] Official Stamp: