Form 19A

Courts of Justice Act

DEFAULT JUDGMENT (DEBT OR LIQUIDATED DEMAND)

(General heading)

(Court seal)

judgment

On reading the statement of claim in this action and the proof of service of the statement of claim on the defendant, filed, and the defendant having been noted in default,

1.    IT IS ORDERED AND ADJUDGED that the defendant pay to the plaintiff the sum of $ ......................... and the sum of $ ......................... for the costs of this action.  (Where costs are to be assessed, substitute the costs of this action as assessed by the court.)

This judgment bears interest at the rate of ................... per cent per year from its date.


Date

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

Issued by

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

Local Registrar

Address of
court office

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

RCP-E 19A (November 1, 2005)