Every person giving notice of his intention to apply for admission under the preceding paragraph shall at the same time lodge with the Registrar of the High Court of New Zealand at the registry where the application is to be made the certificate of his previous admission and a statutory declaration in the following form:
In the matter of the Law Practitioners Act 1931 and in the matter of the application of AB, a barrister and solicitor of the Supreme Court of Victoria, to be admitted a barrister [or solicitor] [or barrister and solicitor] of the High Court of New Zealand.
I, AB, of [specify], do solemnly and sincerely declare as follows:
8 I am known to CD of [specify] and EF of [specify], 2 respectable householders resident in the Dominion of New Zealand, and I refer to the said CD and EF as to any inquiries that may be made respecting myself.
And I make this solemn declaration conscientiously believing the same to be true and by virtue of the Justices of the Peace Act 1927.
Declared at [place, date] before me—
(Justice of the Peace [or solicitor, or Notary Public, etc])