23. Annex A2 - Model layout for statutory declaration/affidavit

STATUTORY DECLARATION/AFFIDAVIT   

In the matter of Trade Mark application/s

no/s..............................for the Trade Mark

..........................................in the name of

.................................................................

1. [Insert translator's declaration if appropriate.]   

2. I, [name], of [address], being the [position of declarant] of [company], a position which I have held since [year], solemnly declare that the evidence herein comes from [source of information] and I am duly authorised to speak on my company's behalf in the prosecution of this application.   

3. The Trade Mark [application number] was first used in [area, state or country] in [month and year] by [name of first user], who is/are [the applicant/s  / the predecessor in title of the applicant/s].

[More explanation may be given if appropriate].

4. The goods and/or services in respect of which the trade mark has been used and the date of first use are as follows:

[item or group of items] first used in [year]   

5. Exhibits demonstrating use of the trade mark [exactly as applied for / in the form/s actually used by the applicant] are attached to this [statutory declaration / affidavit] and are listed as follows: [insert list clearly identifying exhibits. These should be submitted in electronic format via the online services page. Please follow the guidelines on file types and file sizes when using the online services page​​​​​​​.

6. Turnover* figures for the [number] years immediately prior to the date of filing are as follows: [insert list showing each year, corresponding amount in Australian dollars, and corresponding  number of units/transactions].

AND/OR

Turnover* figures since filing are as follows: [insert list showing each year, corresponding amount or estimate in Australian dollars, and corresponding number of units/transactions].

* Note: state whether figures are ex-factory, wholesale or retail (in the case of goods), or are fees for services rendered.

7. The trade mark has been used upon the goods/services in the following states and territories of Australia : [insert list]   

AND has also been used in overseas jurisdiction/s [insert list]   

OR The trade mark has not been used upon the goods/services in Australia, but has been used in the following overseas jurisdiction/s: [insert list]   

8. The trade mark has been promoted by means of: [list advertising media and strategies used] and the following sums expended annually on advertising: [list amounts or estimates of expenditure by year].   

9. Any other relevant information.   

10. EITHER

And I make this solemn declaration conscientiously believing the same to be true under the provisions of [insert name and year of Act under which declaration is made].

OR

And I make this Affidavit conscientiously believing it to be true.

[SIGNATURE]

[INSERT DATE]

[State place at which declaration is made]

and

[SIGNATURE OF AUTHORISED WITNESS]