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C-14 - Railway Act

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4
(Section 173)

Claim of Foreman, Workman, Labourer, or Person who has sold Right of Way or supplied Materials (as the case may be) filed in the Office of the President of the Société immobilière du Québec.

To the President of the Société immobilière du Québec,

Sir,

In presence of the undersigned witness, I, (or we) (name of the foreman, workman, etc., as the case may be) declare that A. B., (name of the company, contractor or subcontractor, as the case may be) owes me (or us) a sum of .............. dollars for (indicate the nature of the work, etc.,) at (place), which sum the said A. B. (name of the company, contractor or subcontractor, as the case may be), refuses or neglects to pay me (or us).

..............
(Signature of workman or workmen, etc.)

Sworn before me at .............., this .............. day of .............., 19..............

G. H.,

Justice of the Peace (or as the case may be).
R. S. 1964, c. 290, form 4; 1973, c. 27, s. 20; 1983, c. 40, s. 63.
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