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Discrimination toolkit

Sample affidavit

Sample affidavit

IN THE FEDERAL File number:     SYD XXXX   


REGISTRY:       Sydney      Court date
Court time

   Sally Marie Anderson  

   Martina Stavos  
First Respondent

   XYZ Company Pty. Ltd.  
Second Respondent


Name of deponent:    Sally Marie Anderson  

Date affirmed:    3 / 9 / 2014  

I,    Sally Marie Anderson  
of    444 Princes Highway, Birchville in NSW          and
   Full time parent                                   affirm:

Filed on behalf of    Applicant Sally Marie Anderson  

Prepared by    Pravin Singh, solicitor    Lawyer's code   2011123  

Name of law firm    Birchville Legal Services  

Address for service in Australia     22 Smith Road, Birchville     
                                        State  NSW  Postcode  2374 
Email    psingh@bls.com.au                              DX  216533 
Tel   (02) 5463-1111   Fax   (02) 5463-1112   Attention   psingh   

  1. I was born on 1 January 1976 and am 38 years of age. I am currently on the Parenting Payment Single and have the full time care of my child Ben, who was born on 10 May 2010.
  2. Since leaving school in 1994 I have had a number of jobs in the hospitality and service industry and have only been unemployed for short periods.
  3. I was employed by XYZ Company Pty. Ltd. between 12th June 2005 and 19th December 2013. I was employed as a shop assistant and my duties mainly involved serving customers who entered the store. At the end of the financial year I would help with the stocktake. When I was asked to leave work in December 2013 I was earning $650 per week gross including superannuation.
  4. On 5th December 2013 I told my direct supervisor, Martina Stavos,

I am pregnant. It's about four months. I would like to take some time off from about March 2014. I would be really grateful if you could find out how much maternity leave I am entitled to.

I can remember that my supervisor did not look very pleased and only replied,


  1. On or about 12th December 2013 my supervisor came to see me and said,

Business is not as good this Christmas as we had expected. I may have to cut down some of your hours. It may even be necessary for you to have some time off without pay.

  1. On 19th December 2013 I asked my supervisor about what she had said in the preceding week. She said,

Look I'm really sorry, I am going to have to let you go. It's not me, it's the boss. He just doesn't think that you should be working while you're pregnant. Don't worry, you can have your job back after you've had the baby.

I felt really bad about what my supervisor had said but did not know what to say in reply.

  1. That afternoon my supervisor handed me my final pay cheque and said

Give me a call after the baby is born.

I replied,

OK. I expect to be back around the end of July.

This was the last day I worked at XYZ Company.

  1. In mid June 2014 I met a friend, Winny Cheng, who worked for XYZ Company Pty. Ltd. and I told her,

I will be coming back to work in about six weeks.

She said,

Really? I thought you had left. That's a bit strange, they have given your job to someone else.

  1. The next day I rang XYZ Company Pty. Ltd. and spoke to the Human Resources Manager, Michelle Green. She said,

I thought it was pretty clear that you weren't coming back so I have given your job to someone else. There is nothing I can do. I cannot sack her.

  1. I was really shocked when I heard this. I felt sick in the stomach and could not sleep that night. I felt that I had been unfairly treated and began to feel very depressed. I went to see my doctor, Dr Scarlett, at the Birchville Medical Centre, and he prescribed anti-depressants and referred me to a counsellor.
  2. I have tried looking for another job but have not yet been able to find one. I have applied for a number of jobs, including shop assistant work at ABC Stores and DEF Ltd, but have been unable to get an interview. I feel that I have lost a lot of confidence and do not trust people as much as I used to.
Affirmed by the deponent  Sally Marie Anderson  
at (place)    Birchville                                                       
on (date)    3 / 9 / 2014                         Signature of deponent
Before me: Pravin Singh

Signature of witness:                            
Full name of witness:    Pravin Singh            
Qualification of witness:  Solicitor of applicant