Form 16A

Courts of Justice Act

ACKNOWLEDGMENT OF RECEIPT CARD

(General heading)

TO (full name)

You are served by mail with the documents enclosed with this card in accordance with the Rules of Civil Procedure.

You are requested to sign the acknowledgment below and mail this card immediately after you receive it.  If you fail to do so, the documents may be served on you in another manner and you may have to pay the costs of service.

ACKNOWLEDGMENT OF RECEIPT

I ACKNOWLEDGE that I have received a copy of the following documents: (To be completed in advance by the sender of the documents.  Include sufficient particulars to identify each document.)

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

Signature of person served

(The reverse side of this card must bear the name and address of the sender and the required postage.)

RCP-E 16A (November 1, 2005)