File Number

	ACT CIVIL AND ADMINISTRATIVE TRIBUNAL

AFFIDAVIT BY CORPORATION REPRESENTATIVE

		Applicant

 		Respondent

I _________________________________________________________________________
(name of person)

of __________________________________________________________________________
(address)

__________________________________________________________________________
(job or position name)

Say on oath/solemnly affirm-

1.	I am an officer of the corporation (name of corporation) and hold the position of (position title)

2.	I have been authorised by the corporation to represent it in this application.

3.	My authority is current and valid. It has not been revoked.

4.	I know that I may be liable to pay some or all of the costs of these proceedings.

5.	Annexed to this affidavit is a copy of the document that authorises, or proves, that I am authorised to represent the corporation in this application. The annexure is marked with the letter “A”.

[Sworn/Affirmed] by _____________________________________________
(full name)

(signature of person making the affidavit)

At__________________________ in the presence of_________________________
                     (place)                                                                   (Signature)

______________________________________of___________________________________ (name of person before whom affidavit is made)                                (address)

*[Justice of the Peace/Barrister/Solicitor/(other)]
*This affidavit is filed on behalf of the applicant/respondent/other
* strike out what does not apply