TO:       JAY CHAUHAN
            Barrister and Solicitor
            330 Highway 7 East, Suite 309
            Richmond Hill, Ontario
            L4B 3P8
            Telephone: (905) 771-1235
            Facsimile:   (905) 771-1237
            Email: jaylawyer@hotmail.com  

Please complete the following instructions to commence action in the small claims court.

1.  Client’s Name and Address

Name:
Address:


Telephone Number:
Email:

2.  Name of Defendant(s)

(i)  Name:
     Address:


(ii)  Name:
      Address:



3.  Describe Briefly Reason for Action






4.  Fees

I understand that claim is prepared in my name and the fees charged are only for the claim being prepared and if representation is required in the small claims court there will be additional cost. I agree to pay the fees upon completion of the claim.

___________________________
Date

__________________________________________________
Client’s Signature