Statutory declaration – sample text

3.5 GHz second assignment round – sample form
 

I, [Name] of [Place, Occupation], solemnly and sincerely declare that:

1. I am employed and authorised by [Company] to make this declaration on its behalf [if applicable – otherwise amend to reflect correct relationship – i.e. owner/director].
2. I declare that:
   1. the Area Spectrum Licences [Company] is applying for will be used to provide a Fixed Wireless Access service; and
   2. neither [Company] nor any of its Associate¹ , has a Controlling Interest in sufficient alternative spectrum rights or radio licences (excluding general user rights and licences) for the provision of Fixed Wireless Access services or in a substitute broadband delivery system which could reasonably be used to provide the proposed Fixed Wireless Access service; and
   3. that [Company] and its Associates will, if successful in its application for every Area Licence applied for under this call for applications, have a Controlling Interest in Area Licences covering no more than ten Territorial Local Authority areas; and
   4. [if the applicant is not a publicly listed company, it must list its principals including board members, directors, Chief Executive Officers and Senior Managers (or similar) and its ultimate owners (beneficial or otherwise and including significant shareholders, parent companies and holding companies)]; or
   5. [if the applicant is a trust, it must list all of its trustees and the ultimate beneficiaries of the trust.]

And I make this solemn declaration conscientiously believing the same to be true and by virtue of the Oaths and Declarations Act 1957.

 
 
[Signed]

Declared at [Place] this [ ] day of [ ] 20[ ].

[Signed by a Justice of the Peace or other person authorised to take a statutory declaration in terms of section 9 of the Oaths and Declarations Act 1957]²

¹For the purposes of this declaration, person A is an associate of person B (and vice versa) if:

1. person A is a body corporate, and person B is (i) a director of that body corporate; or (ii) a Related Body Corporate of that body corporate; or (iii) a director of a Related Body Corporate of that body corporate; or (iv) a partner of the body corporate in terms of the Partnership Act 1908 in a Business; or
2. person A is a spouse, civil union partner, de facto partner, child (including step-child), or parent (including step-parent) of person B; or
3. person A is a nominee or trustee for person B; or
4. person A is a partner of person B in terms of the Partnership Act 1908 in a Business; or
5. person A is a director of a body corporate, or person A holds any voting power in the body corporate, and person A and person B are parties to an agreement relating to (i) the control of that body corporate; or (ii) at least 20% of the voting power in that body corporate; or
6. person A holds or controls directly or indirectly at least 20% of the voting power, or at least 20% of the issued shares, in person B; or
7. person B (or a director, employee or other Associate of person B) is the trustee of a trust acting in that capacity and person A is a settlor, beneficiary, or trustee, of that trust; or
8. person A is a person who, in making a decision or exercising a power materially affecting a Business, is accustomed, or under an obligation, or proposes or is likely (in the Chief Executive’s sole opinion), to act in accordance with the directions or instructions or wishes of person B; or
9. person A and person B are acting, or propose or are likely to act (in the Chief Executive’s sole opinion), jointly or in concert in relation to a Business; or
10. person A (being a person other than the Chief Executive) and person B are parties to an Agreement that entitles one of the persons to the Agreement to a substantial degree of influence, or the right to obtain a substantial degree of influence, over radio frequency spectrum in respect of which the other person is or will be (subject to these Terms and Conditions) a rightholder under the Act; or
11. person A is an Associate of another person that is an Associate of person B under these Terms and Conditions, including an Associate in a chain of Associates;
    For the avoidance of doubt, a commercial arm lengths Agreement between any persons which solely enables one person to use the other person’s spectrum rights will not, of itself, be considered to result in that person being an Associate of the other person.

²Examples of persons able to take declarations - a person enrolled as a barrister and solicitor of the High Court; a Justice of the Peace; a notary public; the Registrar or a Deputy Registrar of the Supreme Court; Court of Appeal; High Court or a District Court; a member of Parliament; or an employee of Public Trust authorised for that purpose.