Subject to the definition of "spouse or common-law partner" this declaration will serve to designate an individual as a common-law partner for purposes of the Isolated Post and Government Housing Directive and for the relevant benefits to be accorded thereunder.

We, ______________________________ and _____________________________ solemnly declare that our relationship is and has been demonstrated by our cohabitation in a conjugal relationship. This relationship is and has been recognized for a period of at least one year in the community or communities in which we have lived. ***

Where these conditions cease to exist we acknowledge the right of the deputy head to cease payments made on the basis of the existence of such conditions.

Where these conditions do not in fact exist we acknowledge the right of the deputy head to recover the amounts of money paid on this basis.

*** In specific cases, this declaration may be used where there has been a break in the period of cohabitation for reasons beyond the control of the employee or the individual to be designated as common-law partner.

Signed _____________________________ Employee

___________________________________ Common-law partner

___________________________________ Date

Signed _____________________________ for the Deputy Head

___________________________________ Date