FORM 4C, Courts of Justice Act, BACKSHEET

RCP-4C-E (2016/05) FORM 4C Courts of Justice Act BACKSHEET (Short title of proceeding) ( court file no.)(Name of court ) PROCEEDING COMMENCED AT (place) (Title of document) (if affidavit, indicate name of deponent and date sworn) (Name, address, telephone number, fax number (if any) and e-mail address (if any) of lawyer or party) (Law society membership number of lawyer) (Fax number, if known, and e-mail address, if known, of person on whom document is to be served)

RCP-4C-E (2016/05) FORM 4C . Courts of Justice Act . BACKSHEET (Short title of proceeding) (Court file no.)

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Transcription of FORM 4C, Courts of Justice Act, BACKSHEET

1 RCP-4C-E (2016/05) FORM 4C Courts of Justice Act BACKSHEET (Short title of proceeding) ( court file no.)(Name of court ) PROCEEDING COMMENCED AT (place) (Title of document) (if affidavit, indicate name of deponent and date sworn) (Name, address, telephone number, fax number (if any) and e-mail address (if any) of lawyer or party) (Law society membership number of lawyer) (Fax number, if known, and e-mail address, if known, of person on whom document is to be served)