Court File Number
Form 14A: Affidavit (general) dated
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(page 2)
Put a line through any blank space left on this page.
Sworn/Affirmed before me at
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municipality
in
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province, state or country
on
. . . . . . . . . . . . . . . . . . . . . . . . .
Signature
Commissioner for taking affidavits
date
This form is to be signed in front of a lawyer,
(Type or print name below if signature is illegible.)
justice
of
the
peace,
notary
public
or
commissioner for taking affidavits.)
FLR 14A (September 1, 2005)
(Français au verso)