In the District Court of

No.                       of 19            .

Between

A. B.,

Plaintiff,

and

C. D.,

Defendant.

The undermentioned Defendant enters an appearance in the above action.

He defends in person (a) ; or

The name of his advocate is                                 

His address for service is (b)                                 

Name of Defendant (c)                                 

C.D. of                                 

(Signed)                                 

(d) Advocate for (d) Defendant.

I certify that the above memorandum was delivered to me to-day, the                       day of                                  19            .

[L.S.]

Registrar.                                 

(a) Strike out whichever of these alternatives is inapplicable.

(b) Give the full name, occupation and address of a person within the municipal limits of the town or village in which is situated the Registry in which the action is filed.

(c) Or Defendants if appearing by the same advocate in the same action at the same time : see O. 16, r. 6. In such a case the necessary changes for the plural should be made in the form.

(d) Strike out the words between if inapplicable.