D 16
CAP. 336]
District Court Civil Procedure (Forms) Rules
[1983 Ed.
[Subsidiary]
L.N. 183/70.
Amount claimed
Fixed costs and court fees
Additional costs and court fees on judgment
Total
*Less total amount paid by the Defendant(s) to the Plaintiff(s)
since the issue of the writ
Net Total
$
69 69
$
69
pursuant to leave granted on the
..... day of
19....
by the above-mentioned Court in accordance with the provisions of that rule.
Dated this.....
day of
• Delete whichever is inapplicable.
+ Name of Registrar.
I,
OF
19.......
Seal of the Court.
*Plaintiff(s){Solicitor/Counsel.
SEE OVER
„(Reverse as in Form 17 or Form 18)
FORM 17
AFFIDAVIT GROUNDING APPLICATION FOR ENTRY OF JUDGMENT IN DEFAULT OF DEFENCE-DEBT OR LIQUIDATED DAMAGES
(reverse)
[title as in Form {]
make oath/do solemnly, sincerely and truly declare and affirm* and say that-
1. *I am the plaintiff in the above action.
*I am the solicitor for the above-named plaintiff and am duly authorized by
him to make this affidavit/affirmation.
*I am the sole proprietor, partner, manager, salesman of the plaintiff firm and I am duly authorized by the plaintiffs to make this affidavit/affirmation.
*I am one of the plaintiffs in the above action and I am duly authorized by
my co-partners to make this affidavit/affirmation.
and the facts deposed hereto are within my own knowledge.
2.
The defendant(s)*
is/are justly and truly indebted to
in the sum 1st defendant(s)*
plaintiff firm of $
for (describe the claim) and was so indebted at the commencement of this action.
me
3.
The particulars of the said claim appear by the endorsement on the writ in this action.
4. *Since the commencement of this action the sum of $
has been paid to the plaintiff(s) on account of the said debt. The defendant(s) is still justly and truly indebted to the plaintiff(s) in the sum of $