Author: Brind'Amour, Justin
Company: Courts Administration Service

SCHEDULE(Section 48)
Federal Court
Between
A.B.
Plaintiff
and
Her Majesty the Queen
Defendant
STATEMENT OF CLAIM
Facts
(State with convenient certainty the facts on which the plaintiff relies as entitling the plaintiff to relief.)
Relief Sought
The plaintiff therefore claims as follows:
•	(a) 
•	(b) 
Dated at  the  day of , 20
(Signature)
Counsel for Plaintiff
(or the plaintiff himself or herself if the plaintiff acts for himself or herself)
•	R.S., 1985, c. F-7, Sch.
•	2002, c. 8, s. 58