Form 58C

Courts of Justice Act

certificate of assessment of costs

(General heading)

certificate of assessment of costs

I CERTIFY that I have assessed the costs of (identify party) in this proceeding (or as may be) under the authority of (give particulars of order or specify rule or statutory provision), and I ALLOW THE SUM OF $.........................

(Where postjudgment interest is payable, add:)

THE COSTS ALLOWED IN THIS ASSESSMENT BEAR INTEREST at the rate of ......................... per cent per year commencing on (date).

Date ......................................................................	......................................................................
	Assessment officer

RCP-E 58C (November 1, 2005)