<p> Form 49 [Rule 13.19]</p><p>COURT FILE NUMBER Clerk’s Stamp COURT COURT OF QUEEN’S BENCH OF ALBERTA</p><p>JUDICIAL CENTRE </p><p>PLAINTIFF(S) </p><p>DEFENDANT(S) </p><p>DOCUMENT AFFIDAVIT</p><p>ADDRESS FOR SERVICE AND CONTACT INFORMATION OF PARTY FILING THIS DOCUMENT</p><p>AFFIDAVIT OF [name]</p><p>Sworn (or Affirmed) on [date], 20 </p><p>I, , of Alberta, SWEAR/AFFIRM AND SAY THAT:</p><p>1. 2. 3. </p><p>SWORN (OR AFFIRMED) BEFORE ME at [City], ) Alberta, this [Date] day of [Month], 20[Year]. ) ) ) ______) ______(Commissioner for Oaths in and for the Province ) (Signature) of Alberta) ) ) ) ______) ______PRINT NAME AND EXPIRY/LAWYER ) (Print Name) /STUDENT-AT-LAW</p><p>This is exhibit __ referred to in the affidavit of ______sworn before me on ______, 20______.</p><p>______</p><p>A Commissioner of Oaths for the Province of Alberta</p><p>______PRINT NAME AND EXPIRY/LAWYER /STUDENT-AT-LAW</p>