Federal Courts Rules (SOR/98-106)

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 the answers set out in Exhibit A to this affidavit to the questions dated (date) submitted by the (identify examining party) are true, to the best of my information, knowledge and belief:

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)

Exhibit A

(Set out the answers to the questions concisely, each in a separate paragraph and numbered consecutively.)