Affidavit (Motion for Payment Out of Court) (Form 4B) – Rules of the Small Claims Court – Ontario Court Services

The Affidavit (Motion for Payment Out of Court) (Form 4B) is a legal document used in the Superior Court of Justice and Small Claims Court in Ontario. It supports a motion requesting the release of funds held in court, typically belonging to a person under a disability. This affidavit form ensures that there is a formal and legally recognized request for the disbursement of funds held by the court, supporting transparency and accountability in handling such financial matters.

Follow these steps to fill out this form:

Court Information

1. • Superior Court of Justice/Small Claims Court: Enter the name of the court.
   • Claim No.: Write the claim number associated with the case.
   • Address: Provide the address of the court handling the case.
   • Phone Number: Enter the court’s contact number.

Parties Involved

1. • Plaintiff(s)/Creditor(s): Write the name(s) of the plaintiff(s) or creditor(s).
   • Defendant(s)/Debtor(s): Write the name(s) of the defendant(s) or debtor(s).

Affiant Details

1. • Full Name: Enter your full name.
   • Municipality & Province: Provide the municipality and province where you live.

Person Under Disability

1. • Name: Enter the full name of the person under disability.
   • Address: Provide the address of the person under disability.
   • Nature of the Disability: State the type of disability the person has.
   • Date of Birth: Enter the date of birth of the person under disability.

Affiant’s Connection to the Person Under Disability

1. • Connection: State your relationship or connection with the person under disability (e.g., parent, legal guardian).

Funds in Court

1. • Amount in Court: Write the amount of money, including interest, that is currently held in court.
   • Date: Enter the date when the amount was confirmed by the accountant.
   • Previously Paid Amounts: Provide details of any previous amounts paid out, including dates and sums.

Proposed Payment

1. • Amount: Specify the amount you propose to be paid out of court.
   • Recipient: Write the name of the person who will receive the money.
   • Purpose: Clearly state what the recipient will do with the money (e.g., medical expenses, education).

Reasons for Payment

1. • Justification: List your reasons for why the money should be paid out of court. Use numbered paragraphs for clarity.

Swearing/Affirming the Affidavit

1. • In Person
     • Location: Fill in the city, town, or municipality, and the county or regional municipality where the affidavit is sworn.
     • Date: Provide the date of swearing.
     • Signatures: Include the signatures of the commissioner and the deponent (you).
   • By Video Conference
     • Deponent’s Location: Enter your name, city, and regional municipality.
     • Commissioner’s Location: Provide the commissioner’s city and regional municipality.
     • Date: Enter the date when the affidavit is sworn.
     • Regulation Compliance: Confirm that the swearing complies with O. Reg. 431/20.
     • Signatures: Ensure both the commissioner and deponent sign the document.

Final Warning

1. • Acknowledgment: Understand that it is an offence under the Criminal Code to knowingly swear or affirm a false affidavit.

Tips

• Accuracy: Double-check all information for accuracy.
• Clarity: Ensure that your reasons and justifications are clear and detailed.
• Legal Advice: Consider seeking legal advice to ensure all sections are correctly filled out.
• Attachments: Attach additional pages if more space is needed for justifications or explanations. Initial all extra pages.

Following these steps carefully will help ensure that the Affidavit (Motion for Payment Out of Court) (Form 4B) is completed accurately and thoroughly.