SJ-1078A (2013-05) - Application to withdraw exhibits or for the

Procedure
APPLICATION TO WITHDRAW EXHIBITS OR FOR THE ISSUE OF A CERTIFICATE
INFORMATION ON THE FILE AND THE CLIENT
File number
I am
Given name and surname
the party or
applicant
the party’s attorney:
defendant
other (specify):
Telephone number:
Other telephone number:
I will retrieve the exhibits or certificates at the courthouse
Box number:
I ask that the exhibits or certificates be sent to the following address:
APPLICATION FOR A CERTIFICATE
Note: Please contact the clerk to find out whether you must provide documents to obtain a certificate.
Quantity
Certificate of divorce
Quantity
Certificate of non-appeal (3073 C.C.Q.)
Date of judgment in question:
Quantity
Other certificate (please specify):
Quantity
Other certificate (please specify):
APPLICATION TO WITHDRAW EXHIBITS (attach an appendix if necessary)
Exhibit
Classification
code in the
plumitif:
Exhibit
Classification
code in the
plumitif:
Exhibit
Classification
code in the
plumitif:
Exhibit
Classification
code in the
plumitif:
Exhibit
Classification
code in the
plumitif:
Year
Signature
Month
Day
Date
ACKNOWLEDGMENT OF RECEIPT OF THE EXHIBITS
I, the undersigned,
, acknowledge receipt of the exhibits mentioned above.
Year
Signature
Date
RESERVED FOR COURT OFFICE STAFF
Année
Reçu le
Mois
Jour
Année
Mois
Jour
Par
Traité le
• SJ-1078A (2013-05)
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