Form 25—Application to vary or set asideForm 25—Application to vary or set aside determination limiting liability

Form 25—Application to vary or set aside determination limiting liability

(subrule 64(1))

(Title)

APPLICATION TO VARY OR SET ASIDE DETERMINATION LIMITING LIABILITY

1. Applicant: 1

2. Determination sought to be set aside or varied: 2

3. Nature of claim against applicant for determination to limit liability: 3

4. I apply to have the determination set aside/varied4 as follows: 5

5. I have not been served with initiating process in that proceeding.

6. insert name, address and occupation of applicant

7. insert particulars of determination to be set aside or varied

8. set out short particulars of the claim

9. strike out whichever is not applicable

10. insert details of variation sought