Ontario Land Tribunal 655 Bay Street, Suite 1500, Toronto, ON M5G 1E5 Tel: 416-212-6349 | 1-866-448-2248 Web Site: olt.gov.on.ca

Affidavit of Service

Applicant(s)/Appellant(s):
Subject:
Property Address/Description:
Municipality:
Municipal File/Reference No:
OLT Case No.:
OLT File No.:
OLT Case Name:
Affidavit file on behalf of:

AFFIDAVIT OF

I, of , in the , MAKE OATH AND SAY (or AFFIRM):

On At AM PM
I served by:

Method of Delivery (email, mail, courier etc.)		Party that was served (Full Name – First, Middle Last Name or Single Name)		Specify which physical or email address party was served at (Address: Street Number and Name, Suite/Unit Number, City/Town, Province, Postal Code)
	Upon		At

Sworn (or Affirmed) before me at the of in the
of on , 20

(This form is to be signed in front of a lawyer, justice of the peace, notary public or commissioner for taking affidavits.)