Provincial Gourt of Alberta

(Givil)

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Plaintiff(s)

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Defendant(s)

Givil Claim
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and costs of this action.

The Claim arose at

The reasons for the Claim are:

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| abandon that part of my Claim that exceeds the financial jurisdiction of this Court.

I understand and agree that I cannot recover in this Court or any other Court the part of my Claim that is abandoned.

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The Defendant's address is:

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The Defendant's address is:

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The Court's Address is:

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Ph: 403-297*721
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Website address: www.albertacourts.ab.ca

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c'ts1461 (2012t12)

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Notice to Defendant
Within 20 days of receiving this Civil Claim (30 days if served outside of
Alberta) you must:

1.

Pay to the Coutt office the amount of the Civil Claim plus costs (contact the
Court office) by cash, certified cheque, money order or debit card (if
available) only. A court appearance will not be necessary if you choe thb
option.

or

2.

Dispute the Civil Claim by completing and then delivering the attached form
of Dispute Note in person to any Court office, or by mailto the address
shown on the Civil Claim, along with the applicable filing fee.

The applicable filing fees are:

Counterclaim

Dispute Note without a

Dispute Note with a Counterclaim valued at $7500 or
Dispute Note with a Counterclaimvalued greater than

less

$7500

$
$

25.00
75.00
$125.00

The Court office must receive the form of the Dispute Note along with the
applicable filing fee within the 20 (30) day time limit.

lf you do not pay or dispute the Civil Claim, judgment may be entered
against you for the amount of the Claim, interest and costs.

It is your responsibility to notify the Gourt office of any change in your

address.

cTs1461 (2016/03)