Form 4D

Courts of Justice Act

affidavit

(General heading)

affidavit of (name)

I, (full name of deponent), of the (City, Town, etc.) of ........................., in the (County, Regional Municipality, etc.) of .........................,(where the deponent is a party or the solicitor, officer, director, member or employee of a party, set out the deponent’ capacity), MAKE OATH AND SAY (or AFFIRM):

1. (Set out the statements of fact in consecutively numbered paragraphs, with each paragraph being confined as far as possible to a particular statement of fact.)

Sworn (or Affirmed) before me at the (City, Town, etc.) of
...............................................................................................
in the (County, Regional Municipality, etc.) of ....................

............................................................................. , on (date).



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

   







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

Commissioner for Taking Affidavits
(or as may be)

   

(Signature of deponent)

RCP-E 4D (November 1, 2005)