© UAE Certification Guidelines 2017

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Attachment 8 - UAE Statutory Declaration Form

UNITED ARAB EMIRATES (UAE) STATUTORY DECLARATION FORM

Applicant details:

SURNAME:

Title (Dr, Prof, Mr, Mrs, Ms):

GIVEN/FIRST name:

Applicant address (residence):

I, the aforesaid applicant, do hereby solemnly declare and affirm that:

Declared at

Place:

Area: Emirate State / Province:

Date:

Signature of Applicant

In the presence of the authorised proxy:

SURNAME:

GIVEN/FIRST name:

Position / Title: Company Name (if applicable): Date:

Signature of Proxy

Proxy Declaration: I have known the person for at least 12 months OR I have confirmed the person’s identity using an identification document and the document I relied on was EXAMPLE ONLY I certify the following matters concerning the making of this statutory declaration by the person who made it: I saw the face of the person OR I did not see the face of the person because the person was wearing a face covering.

COPYRIGHT © 2017 Case Management Society of Australia and New Zealand and Affiliates (CMSA)

C E R T I F I E D C A S E M A N A G E R S U N I T E D A R A B E M I R A T E S

C A S E M A N A G E M E N T S O C I E T Y O F A U S T R A L I A & N E W Z E A L A N D & A F F I L I A T E S 1 9 9 6

The Case Management Society of Australia and New Zealand and Affiliates (CMSA) Certification sets the benchmark of excellence in case management. Certified Practising Case Managers™ (CPCM) and Certified Case Managers (Non Practising)™ (CCMNP) adhere to the CMSA National Standards and National Code of Ethics for Case Management and are recognised for their advanced education, experience, knowledge and skills by their colleagues, consumers and employers. The Case Management Society of Australia and New Zealand and Affiliates (CMSA) Certification sets the benchmark of excellence in case management. Certified Practising Case Managers™ (CPCM) and Certified Case Managers (Non Practising)™ (CCMNP) adhere to the CMSA National Standards and National Code of Ethics for Case Management and are recognised for their advanced education, experience, knowledge and skills by their colleagues, consumers and employers.