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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 and fax number of solicitor or party Law society registration number of solicitor Fax number if known of person on whom document is to be served RCP-E 4C November 1 2005.

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