ONTARIO
Court File Number
(Name of Court)
Form 23C: Affidavit for
at
Uncontested Trial, dated
Court office address
Applicant(s)
Full legal name & address for service — street & number, municipality,
Lawyer’s name & address — street & number, municipality, postal
postal code, telephone & fax numbers and e-mail address (if any).
code, telephone & fax numbers and e-mail address (if any).
Respondent(s)
Full legal name & address for service — street & number, municipality,
Lawyer’s name & address — street & number, municipality, postal
postal code, telephone & fax numbers and e-mail address (if any).
code, telephone & fax numbers and e-mail address (if any).
My name is
(full legal name)
I live in
(municipality and province)
swear/affirm
and I
that the following is true:
1. I am the applicant in this case.
child(ren) from our relationship, namely:
2. There
is/are
(number)
Now living with
Birthdate
Resident in
Full Legal Name
Age
(name of person and
(d, m, y)
(municipality & province)
relationship to child)
3. I am asking for the following order:
custody of the child(ren) named above
access to the child(ren) named above
support for
(name of recipient(s))
a restraining order against the respondent
(name)
(date of birth)
other
(specify)
4. The respondent and I were:
married on
(date)
separated on
(date)
started living together on
(date)
never lived together.
FLR-23C-E (2009/09)
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