File number 20____ ____G_________

IN THE SUPREME COURT OF NEWFOUNDLAND AND LABRADOR
GENERAL DIVISION 

BETWEEN:
	(Applicant’s Name) _____________________________________	 APPLICANT

AND:
	(Respondent’s name) ___________________________________ 	RESPONDENT

Order

BEFORE the Honourable __________ Justice _________________;

UPON READING ___________________________________________________________________________________________________________________________________________________________;

AND UPON HEARING ________________________________________________________;

IT IS HEREBY DECLARED AND ORDERED as follows:

1.	

DATED at_______________,(city/town) in the Province of Newfoundland and Labrador, this 	 (day) of _______________(month), 20____(year).

		
	(signature)
	Registrar/Registry Clerk