15-903F Affidavit of Service [BCF]

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15-903F [BCF]
Published: 2001-03-16
Effective: 2001-03-15

This is the form required under section 11 of the Securities Regulation for an affidavit of service.

BC FORM 15-903F

Securities Act
In the Matter of the Securities Act, R.S.B.C. 1996, c. 418
And
In the Matter of Affidavit of Service

I, [name], [occupation], of [address], Province of British Columbia, MAKE OATH AND SAY AS FOLLOWS:

1. On [day], the ________ day of ____________, 20 ___, at the hour of _______ o'clock in the ________ noon, I served [name of individual/company] with the following: [list documents served]

(a) [e.g. a true copy of a summons]

(b) [etc.]

(c) [conduct money in the amount of a $ ]

by leaving the documents [and the conduct money] with [name], [position with company, where applicable], at [address], in the Province of British Columbia.

2. True copies of the [list documents served] are attached to this Affidavit and marked as Exhibits ["A", "B", "C", etc.] respectively.

 

SWORN BEFORE ME at the ___________________ of

________________________, in the Province of British

Columbia, this _____ day of _______________ 20 ____


_____________________________________________


_____________________________________________
A Commissioner for taking Affidavits
for British Columbia

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