Form 20.01A
(rule 20.01(3))

File number: 20____ ____ G __________ 

IN THE SUPREME COURT OF NEWFOUNDLAND AND LABRADOR
GENERAL DIVISION

BETWEEN:			
	(Plaintiff’s name)	PLAINTIFF	
			
AND:			
			
	(Defendant’s name)	DEFENDANT	
			
 (Modify title of proceeding as necessary.)

Notice of Payment into Court

TAKE NOTICE that the defendant has paid the sum of $(insert dollar amount) into Court in satisfaction of (tick one of the boxes)

□ 	the cause (or, where there is more than one, all of the causes of action) for which the plaintiff claims; or 

□	the following causes of action for which the plaintiff claims and the following amounts are paid in respect thereof:

(Set out the cause or causes of action and the respective amount for each.)

(Where there is a counterclaim, you may also insert the following paragraph.)

AND FURTHER TAKE NOTICE that the defendant has offered to surrender the following cause/causes of action in the counterclaim and has reduced the sum paid into Court by the sum of $(insert dollar amount) in allowance therefor: 

(Set out cause or causes of action of the counterclaim and the respective amount for each.)

DATED at _____________ (city/town), _______________________ (province or, if outside of Canada, country), on the ________ (day) of __________________ (month), ________ (year). 
__________________________
(Signature)
Defendant/Solicitor for Defendant 

Whose address for service is: 
(Insert address for service)
Newfoundland and Labrador

TO:	(Each party or the solicitor for the party)
(Insert address)