AFFIDAVIT

 

 

 

 

I, ________________________________________, born on ____________________, holder of

Canadian passport number __________________, hereby affirm on  _________________ that:

 

I receive monthly pension income and/or other types of income in the amount of __________________________________________.

 

The purpose of this affidavit is _____________________________________________________________________________

_____________________________________________________________________________

_____________________________________________________________________________.

 

 

                                                                                    Signed _______________________

 

 

 

 

FOR OFFICIAL USE ONLY

I hereby certify that ____________________________

holder of Canadian Passport __________________ has

produced SATISFACTORY EVIDENCE of his/her identity

and  that the signature appearing on this document is the

signature of the said ____________________________

AFFIRMED/ SWORN BEFORE ME,

at the Embassy of Canada, Bangkok, Thailand,

this_______ day of ____________________, 20___

 

__________________________