Form 62A

Courts of Justice Act

notice of appeal to a judge

(General heading)

notice of appeal

THE (identify party) APPEALS to a judge from the order (or certificate) of (name of judge or officers) dated (date).

THE APPEAL WILL BE HEARD ON (day), (date), at (time) at (address of court house).

THE (identify party) ASKS (state the precise relief sought).

THE GROUNDS OF APPEAL are as follows: (Set out briefly the grounds of appeal).


(Name, address and telephone number of solicitor or party serving notice)

TO (Name and address of solicitor or party on whom notice is served)

RCP-E 62A (November 1, 2005)