FORM 80A - Rule 80

AFFIDAVIT

(General Heading -- Use Form 66)

AFFIDAVIT OF (Name)

	I, (full name and occupation of deponent), of the (City, Town, etc.) of (name) in the (County, Regional Municipality, etc.) of (name), SWEAR (or AFFIRM) THAT:
	
	1. (Set out the statements of fact in consecutively numbered paragraphs, with each paragraph being confined as far as possible to a particular statement of fact.)

Sworn (or Affirmed) before me at  the (City, Town, etc.) of (name) in the (County, Regional Municipality, etc.) of (name) on (date).

______________________________________
Commissioner for Taking Affidavits
(or as the case may be)

_____________________________
(Signature of Deponent)