PLEASE NOTE - this is not a form to fill in, but an example which will assist you in preparing your declaration.

Statutory Declaration

Section 31(6), Highways Act 1980

I  (landowner) DO SOLEMNLY AND SINCERELY DECLARE as follows:

1. I am and have been since (day, month, year) the owner of the land known as (name of farm, etc.) more particularly delineated on the plan accompanying this declaration and thereon edged red.
2. On the (day) day of (month, year) I (or my predecessor in title \{name\} ) deposited with Hampshire County Council, being the appropriate Council, a statement accompanied by a plan delineating my property by red edging which stated that (the ways coloured brown on the said plan had been dedicated as highways for all purposes) (the ways coloured broken green on the said plan had been dedicated as restricted byways)  (the ways coloured green on the said plan had been dedicated as bridleways) (the ways coloured purple on the said plan had been dedicated as footpaths) (no \{other\} ways had been dedicated as highways over my property).
3. * On the (day) day of (month, year) I (or my predecessor in title \{name\} ) deposited with Hampshire County Council, being the appropriate Council, a statutory declaration dated (day, month, year), stating that no additional ways (other than those marked in the appropriate colour on the plan accompanying this declaration) had been dedicated as (highways with vehicular status) (bridleways) (footpaths) since the deposit of the Statement referred to in 2. above.   
4. No additional ways have been dedicated over the land edged red on the plan accompanying this declaration since the statement dated (day, month, year) referred to in 2. above (since the date of the statutory declaration referred to in 3. above) (other than those (highways with vehicular status) (restricted byways) (bridleways) (footpaths) marked in the appropriate colour on the plan accompanying this declaration) and at the present time I have no intention of dedicating any more public rights of way over my property.

( * Delete if not applicable)

AND I MAKE this solemn declaration on the (day) day of (month, year) conscientiously believing it to be true and by virtue of the Statutory Declarations Act 1835.

Declared at (address)(signature of landowner)

Before me

(Commissioner for Oaths or a Justice of the Peace or Solicitor)