You are on page 1of 1

Form 43A

APPENDIX OF FORMS
FORM 43A

NOTICE OF CLAIM
(to execution creditor)

(Court, Court File Number, Style of Proceeding)

NOTICE OF CLAIM
(FORM 43A)

TO: ______________________________________

I have taken (or intend to take, as may be ) into my possession and control the following property (or proceeds
from a disposition of the following property, as may be):

.......................................................................................

.......................................................................................

I have received notice from . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . of the claim in respect of the said property, a
copy of which is attached hereto.

Within 7 days after you receive this Notice you are required to give notice in writing to me as to whether you
admit or dispute such claim.

DATED at . . . . . . . . . . . . . , this . . . . . . . . . . . day of . . . . . . . . . . . . . . .,19. . . . . . .

.......................................
(signature of sheriff)

.......................................
(address of sheriff’s office)

You might also like