Federal Courts Rules (SOR/98-106)

I, (full name and occupation of deponent), of the (City, Town, etc.) of (name) in the (County, Regional Municipality, etc.) of (name), SWEAR (or AFFIRM) THAT:

• 1 I submit myself to the jurisdiction of this Court and consent that if (insert name of party for whom bail is to be given, and state whether plaintiff or defendant, or as the case may be) do(es) not pay what may be adjudged against them (or as the case may be) in this action, with costs, or do(es) not pay any sum due to be paid under any agreement by which the action is settled before judgment and which is filed in this Court, execution may issue against me, my executors or administrators, or my personal property or movables, for the amount unpaid or an amount of $(amount), whichever is the lesser.

(Add where bond given by an individual:)

• 2 I have a net worth of more than the sum of $(state amount in which bail is to be given) after payment of all my debts, as shown by the financial statement attached as Appendix A hereto.

Sworn (or Affirmed) before me at the (City, Town, etc) of (name) in the (County, Regional Municipality, etc.) of (name) on (date).
Commissioner for Taking Affidavits (or as the case may be)	(Signature of Surety)