Declaration To Sheriff
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1
2ONTARIO
Court file number
(Name of Court)
Form 28B: Statutory
at
Declaration to Sheriff
Court office address
Recipient(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).
Payor
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 & province)
and I declare that the following is true:
1. I am
a recipient under a payment order.
an assignee of a recipient under a payment order.
an agent of the Director of the Family Responsibility Office.
other
(Specify.)
2. On
a writ of seizure and sale was issued in this case, a copy of which is attached.
(date)
3. Since then, the amount owed by the payor has changed and, as of today, the amount owed stands at $
with interest on it at the rate of
% per year beginning on
(date when interest begins)
4. Since then, the payor has:
legally changed his/her name from
to
.
used the following alias(es):
.
used the following spelling variation(s) of his or her name or alias(es):
.
5. The amount in paragraph 3 includes unpaid support of $
which, under subsection 4(1) of the
Creditors’ Relief Act, gets priority over other judgments and orders.
6. An additional Assignment of Judgment of Costs in the amount of
$
(write NIL if none)
has been made in favour of Legal Aid Ontario which, under subsections 46(4) and 47(1) of the Legal Aid Services Act, 1998,
must be deducted from the proceeds of the sale and paid to Legal Aid Ontario.
FLR-28B-E (2007/06)
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