Rules of the Supreme Court of Canada

TAKE NOTICE that (name) hereby applies for leave to cross-appeal to this Court, pursuant to (cite the section of the act or these Rules under which the application for leave to cross-appeal is made), from the judgment of the (name of the court appealed from and file number from that court) made (date) and for (insert the nature of order or relief sought) or such further or other order that the said Court may deem appropriate;

AND FURTHER TAKE NOTICE that this application for leave to cross-appeal is made on the following grounds: (set out concisely and number each ground on which the application is made).

Dated at (place and province or territory) this (date) day of (month), (year).

SIGNED BY (signature of counsel or party or agent)

Respondent (Counsel’s (or party’s, if unrepresented) name, address and telephone number, and fax number and e-mail address (if any))

Agent (if any) (Agent’s name, address and telephone number, and fax number and e-mail address (if any))

ORIGINAL TO: THE REGISTRAR

COPIES TO: (Name, address and telephone number, and fax number and e-mail address (if any), of every party and all other parties and interveners in the court appealed from)

NOTICE TO THE APPLICANT: An applicant may serve and file a memorandum in response to this application for leave to cross-appeal within 30 days after service of the application for leave to cross-appeal.