IN THE SUPREME COURT
OF THE NORTHERN TERRITORY
OF AUSTRALIA
PROBATE JURISDICTION
[DARWIN or ALICE SPRINGS] REGISTRY

No.	

THE ESTATE of the late	
[FULL NAME – CAPITALS AND BOLD]	
late of [address], 	
[occupation], deceased	

AFFIDAVIT

DEPONENT: [FULL NAME - CAPITALS]     
DATE MADE: [DATE]

I, [FULL NAME – CAPITALS] of [address], [occupation], make oath and say that:

1.

2.

3.

MADE ON [date]

……………………………………                            				………………………………………..
Deponent     							Commissioner for Oaths/
Justice of the Peace

4. 

5.

MADE at [Place]
in the Northern Territory of Australia
by [Full name of Deponent]			…………………………………              
on [date]						Signature of Deponent
on [Insert date]

BEFORE ME:

………………………………………                            			
Commissioner for Oaths/
Justice of the Peace

	

IN THE SUPREME COURT
OF THE NORTHERN TERRITORY
OF AUSTRALIA
PROBATE JURISDICTION
[DARWIN or ALICE SPRINGS] REGISTRY

No.

THE ESTATE of the late	
FULL NAME - CAPITALS AND BOLD] late of [address], [occupation],	
deceased	

This is the annexure marked with the letter “A” referred to in the Affidavit of [FULL NAME – CAPITALS AND BOLD]

Made before me on [date]

……………………………………………

Commissioner for Oaths/Justice of the Peace