AFFIDAVIT IN SUPPORT OF PAYMENT OUT OF COURT –

Affidavit in Support of Payment Out of Court – 73.08(3) Page 1 File No. ________________________

THE QUEEN’S BENCH

______________________ Centre

BETWEEN:

Garage Keeper,

-and-

Owner

AFFIDAVIT IN SUPPORT OF PAYMENT OUT OF COURT – TO THE GARAGE KEEPER

I, _____________________________________________, of the (City/Town) of_______________, in

(garage keeper)

The Province of Manitoba, ________________________________________ MAKE OATH AND SAY:

(occupation)

That I have received the Notice of Payment into court under The Garage Keepers Act.

That I have commenced an action in the court following service of the Notice of Payment into court under The Garage Keepers Act and judgment was granted in my favour.

That the amount outstanding on the judgment in this matter is $_________________.

That the portion of the money paid into court that does not exceed the judgment should therefore be paid out to me or my nominee.

Sworn (or Affirmed) before me at the

_______ of _____________________

in the Province of Manitoba,

this ___ day of ____________ , _____

________________________________ Signature

______________________________

Deputy Registrar for Queen’s Bench or ________________________________

A Commissioner for Oaths in and for Print Name

the Province of Manitoba

My Commission expires: _____________