Statutory Declaration
Ministry of
Culture
in the matter of the Foreign
Cultural Objects Immunity From
Seizure Act
I,
,
(name of deponent)
(position held/ title)
of
(name of institution)
which is a cultural and educational institution in Ontario, solemnly declare that I have knowledge of the
matters hereinafter deposed to:
1. The list attached hereto contains a complete and accurate description of each of the works of art or
other objects of cultural significance sought to be brought into Ontario pursuant to an agreement
between the foreign owner or custodian thereof and
(name of institution)
providing for the temporary exhibition at
(name of location where exhibit being held)
and to be protected from seizure under the Foreign Cultural Objects Immunity from Seizure Act.
2. The objects are works of art or objects of cultural significance.
3. The temporary exhibition is in the interest of the people of Ontario.
4. The above works of art or objects of cultural significance are being brought into Ontario from the
following countries: (list countries)
5. I certify that
(name of institution)
has undertaken a professional inquiry, including independent, multisource research, into the
provenance of the works or objects proposed for determinations of cultural significance and provincial
interest. I certify further that I do not know or have reason to know of any circumstances with respect
to any of the works or objects that would indicate the potential for competing claims of ownership.
I make this solemn declaration conscientiously believing it to be true and knowing that it is of the same
force and effect as if made under oath.
Declared before me
At the
of
City/Town. Etc.
in the
of
County, Regional
Municipality, etc.
This
day of
Commissioner for Taking Affidavits
0368 Declaration (03/2003)
, 20
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_________________________________________________________________
Signature of Deponent
_________________________________________________________________
Name of Deponent
_________________________________________________________________
Title/ Position
_________________________________________________________________
Name of Institution
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