I, (full name and occupation of deponent), of the (City, Town, etc.) of (name) in the (County, Regional Municipality, etc.) of (name), SWEAR (or AFFIRM) THAT: (choose which of the following is appropriate and include it in the body of the affidavit:)
Je soussigné(e), (nom, prénoms et occupation du déclarant), de la (du) (ville, municipalité, etc.) de (nom), dans le (la) (comté, municipalité régionale, etc.) de (nom), DÉCLARE SOUS SERMENT (ou AFFIRME SOLENNELLEMENT) QUE :