Form 49.01C
(rule 49.01)
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.)

Summary Order Under rule 17.02
Before the Honourable _________ Justice____________
UPON IT APPEARING THAT the plaintiff has made application under rule 17.02 for a summary order against the defendant on the claim herein;
IT IS ORDERED THAT the defendant 
(pay to the plaintiff the sum of $________ and $ ________ costs (costs to be taxed)).
OR
(pay to the plaintiff damages to be assessed)
OR
(deliver to the plaintiff the goods described in the statement of claim __________ (or pay the plaintiff the value of the goods to be assessed) (and also damages for their detention to be assessed) and costs to be taxed.)
OR
(deliver to the plaintiff possession of the land described in the statement of the claim as _______ and costs to be taxed.)
DATED at 					  (city/town) in the Province of Newfoundland and Labrador this 		 (day) of 			 (month), 		 (year).

(signature)
Registrar/Registry clerk