Form 15a - Change Information Form Page 7

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Form 15A:
Change Information Form
(page 7)
Court file number
OTHER
(Complete if applicable.)
23. I ask that the term(s) of the order of Justice
,
(name of judge)
dated
, for
(give details)
be changed as follows:
(give details of the order you want the court to make)
24. I ask that the court make this order for the following reasons:
Sworn/Affirmed
before me at
municipality
in
Signature
province, state or country
(This form is to be signed in front of a
lawyer, justice of the peace, notary public or
on
commissioner for taking affidavits.)
date
Commissioner for taking affidavits
(Type or print name below
if signature is illegible.)
FLR-15A-E (2016/04)
Page 7 of 9

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