Newfoundland and Labrador Gazette, Part I — 26 February 2021, Vol. 96, No. 8 — Lands Act Notice

NLG 2021-02-26

Newfoundland and Labrador — Gazette

THE NEWFOUNDLAND AND LABRADOR GAZETTE

PART I PUBLISHED BY AUTHORITY Vol. 96 ST. JOHN’S, FRIDAY , FEBRUARY 26, 2021 No. 8 LANDS ACT Notice of Intent,

Section 7 Lands Act, SNL 1991 c36 as amended NOTICE IS HEREBY given that an application has been made to the Department of Fisheries and Land Resources, Agriculture and Lands Branch, to acquire title, pursuant to

section 7(2)(

a) of the said Act, to that piece of Crown lands situated within 15 metres of the waters of east of River of Ponds (unknown lake) for the purpose of consumptive purposes. The application may intrude on the 15 metre shoreline of the above mentioned water body(

s) in various locations. For a detailed map, please see the website below: http://www.ma.gov.nl.ca/lands/sec7notifications.html Please note: It may take up to 5 days from the date of application for details to appear on the website.

Any person wishing to object to the application must file the objection in writing with reasons, within 30 days from the publication of the notice on the Department of Fisheries and Land Resources website, Crown Lands, http://www.ma.gov. nl.ca/lands/index.html, to the Minister of Fisheries and Land Resources by mail or email to the nearest Regional Lands Office: • Eastern Regional Lands Office, P.O. Box 8700, Howley Building, Higgins Line, St. John’s, NL, A1B 4J6 Email: easternlandsoffice@gov.nl.ca • Central Regional Lands Office, P.O.

Box 2222, Gander, NL, A1V 2N9 Email: centrallandsoffice@gov.nl.ca • Western Regional Lands Office, P.O. Box 2006, Sir Richard Squires Building, Corner Brook, NL, A2H 6J8 Email: westernregionlands@gov.nl.ca • Labrador Regional Lands Office, P.O. Box 3014, Station “B”, Happy Valley-Goose Bay, NL, A0P 1E0 Email: labradorlandsoffice@gov.nl.ca (DISCLAIMER: The Newfoundland and Labrador Gazette publishes a NOTICE OF INTENT as received from the Applicant and takes no responsibility for errors or omissions in the property being more particularly described.) Feb 26 Notice of Intent,

Section 7 Lands Act, SNL 1991 c36 as amended NOTICE IS HEREBY given that an application has been made to the Department of Fisheries and Land Resources, Agriculture and Lands Branch, to acquire title, pursuant to

section 7(2)(

a) of the said Act, to that piece of Crown lands situated within 15 metres of the waters of Carey’s Long Pond for the purpose of airplane hangar and wharf. The application may intrude on the 15 metre shoreline of the above mentioned water body(

s) in various locations. For a detailed map, please see the website below: 47

http://www.ma.gov.nl.ca/lands/sec7notifications.html Please note: It may take up to 5 days from the date of application for details to appear on the website. Any person wishing to object to the application must file the objection in writing with reasons, within 30 days from the publication of the notice on the Department of Fisheries and Land Resources website, Crown Lands, http://www.ma.gov. nl.ca/lands/index.html, to the Minister of Fisheries and Land Resources by mail or email to the nearest Regional Lands Office: • Eastern Regional Lands Office, P.O. Box 8700, Howley Building, Higgins Line, St.

John’s, NL, A1B 4J6 Email: easternlandsoffice@gov.nl.ca • Central Regional Lands Office, P.O. Box 2222, Gander, NL, A1V 2N9 Email: centrallandsoffice@gov.nl.ca • Western Regional Lands Office, P.O. Box 2006, Sir Richard Squires Building, Corner Brook, NL, A2H 6J8 Email: westernregionlands@gov.nl.ca • Labrador Regional Lands Office, P.O.

Box 3014, Station “B”, Happy Valley-Goose Bay, NL, A0P 1E0 Email: labradorlandsoffice@gov.nl.ca (DISCLAIMER: The Newfoundland and Labrador Gazette publishes a NOTICE OF INTENT as received from the Applicant and takes no responsibility for errors or omissions in the property being more particularly described.) Feb 26 TRUSTEE ACT ESTATE NOTICE IN THE MATTER of the Estate of JODIE BENOIT CRANN, Late of Stephenville, in the Province of Newfoundland and Labrador, Deceased: January 31, 2021.

All persons claiming to be creditors of or who have any claims or demands upon or affecting the Estate of JODIE BENOIT CRANN, Late of Stephenville, in the Province of Newfoundland and Labrador, Deceased, are hereby requested to send the particulars of the same in writing, duly attested, to the undersigned Solicitor for the Administrator of the Estate on or before the 5 th day of April, 2021, after which date the said Administrator will proceed to distribute the said Estate having regard only to the claims of which notice shall have been received.

DATED AT Stephenville, Newfoundland and Labrador, this 26th day of February, 2021. ROXANNE PIKE LAW OFFICE PER: Roxanne Pike Solicitor for the Administrator ADDRESS FOR SERVICE: P. 0. Box272 43 Main Street Stephenville, NL A2N 2Z4 Tel: (709) 643-6436 Fax: (709) 643-9343 Feb 26 ESTATE NOTICE IN THE MATTER of the Estates of the Late RHODA ENDICOTT and the Late COYLEY ENDICOTT, both of the Town of Rocky Harbour, in the Province of Newfoundland and Labrador, Canada, Deceased.

All persons claiming to be creditors of or who have any claims or demands upon or affecting the Estates of RHODA ENDICOTT and/or COYLEY ENDICOTT, Late of Rocky Harbour, in the Province of Newfoundland and Labrador, Deceased, are requested to send particulars in writing, duly attested, to the undersigned Solicitor for the Executor of the Estate of the Deceased on or before the 26 th day of March, 2021 after which date the Executor will proceed to distribute the Estate having regard only to the claims of which they then shall have had notice. DATED AT Corner Brook, this 19th day of February, 2021.

PENNEY & BROWN LAW PER: Jill K. Brown Solicitors for the Executor ADDRESS FOR SERVICE: 37 West Street Corner Brook, NL A2H 2Y6 Tel: (709) 634-9888 (709) 634-9885 Fax: (709) 634-1497 Feb 26 ESTATE NOTICE IN THE MATTER of the Estate of THOMAS P. KANE Late of Stephenville, in the Province of Newfoundland and Labrador, Deceased: January 26, 2021. All persons claiming to be creditors of or who have any claims or demands upon or affecting the Estate of THE NEWFOUNDLAND AND LABRADOR GAZETTE February 26, 2021 48

THOMAS P. KANE, Late of Stephenville, in the Province of Newfoundland and Labrador, Deceased, are hereby requested to send the particulars of the same in writing, duly attested, to the undersigned Solicitor for the Executor of the Estate on or before the 30’h day of March, 2021, after which date the said Executor will proceed to distribute the said Estate having regard only to the claims of which notice shall have been received. DATED at Stephenville, Newfoundland and Labrador, this 2nd day of February, 2021. ROXANNE PIKE LAW OFFICE PER: Roxanne Pike Solicitor for the Executor ADDRESS FOR SERVICE: P. 0.

Box 272 43 Main Street Stephenville, NL A2N 2Z4 Tel: (709) 643-6436 Fax: (709) 643-9343 Feb 26 THE NEWFOUNDLAND AND LABRADOR GAZETTE February 26, 2021 49

THE NEWFOUNDLAND AND LABRADOR GAZETTE

PART II SUBORDINATE LEGISLATION FILED UNDER THE STATUTES AND SUBORDINATE LEGISLATION ACT Vol. 96 S T. JOHN’S, FRIDAY , FEBRUARY 26, 2021 N o. 8 NEWFOUNDLAND AND LABRADOR REGULATIONS NLR 9/21 NLR 10/21

NEWFOUNDLAND AND LABRADOR REGULATION 9/21 Rules of Supreme Court, 1986 (Amendment) (Amendment) under the Judicature Act (Filed February 25, 2021) Under the authority of

section 55 of the Judicature Act, the Rules Committee of the Supreme Court makes the following Rules. Dated at St. John’s, February 24, 2021. Raymond P. Whalen Chairperson, Rules Committee REGULATIONS Analysis 1. S. 34 Amdt. Forms Amdt. 1. Subsection 34(2) of the Rules of the Supreme Court, 1986 (Amendment) is repealed. ©Queen's Printer NLR 46/20 57 The Newfoundland and Labrador Gazette February 26, 2021

NEWFOUNDLAND AND LABRADOR REGULATION 10/21 Rules of Supreme Court, 1986 (Amendment) under the Judicature Act (Filed February 25, 2021) Under the authority of

section 55 of the Judicature Act, the Rules Committee of the Supreme Court makes the following Rules. Dated at St. John’s, February 24, 2021. Raymond P. Whalen Chairperson, Rules Committee REGULATIONS Analysis 1. Forms Amdt. 2. Commencement 1. The Rules of the Supreme Court, 1986 are amended by repealing and substituting the following forms: F4.03A; F4.04A; F5.05A; F5.06A; F6.02A; F8.03A; F10.02; F11.02; F16.03A; F17.03; F23.01A; F23.02A; F23.05A; F25.03A; F26.02A; F29.02A; F31.02A; F34.02B; F34.02C; F38.04A; F38.04B; F38.06A. 2. These regulations come into force on March 1, 2021. ©Queen's Printer Commencement 59 The Newfoundland and Labrador Gazette February 26, 2021

Form F4.03A: Originating Application (Family Law) – Instructions for the Applicant Supreme Court of Newfoundland and Labrador Rules of the Supreme Court, 1986 (March 2021) Page 1 of 1 How to Make an Originating Application Instructions for the Applicant An Originating Application (Form 4.03A) is a document you must use to start a family law court proceeding. Your Originating Application tells the Court that there are family law issues that you would like to have resolved. If you start an Originating Application, you are the Applicant. The other person is the Respondent.

If you are making an application together with the other person (ie. a joint application), you cannot use this form. You must do a Joint Originating Application (Form F4.04A). Completing Your Originating Application You can fill out this form by hand or you can download and fill out this form electronically at www.court.nl.ca/supreme/family/forms.html (If you fill out the form electronically, you must still print the form, file it with the Court, and serve a copy on the Respondent). You must fill out pages 1 -5 of the Originating Application and attach any schedules and additional forms that apply to you.

If you need more space to fill out any

section of this Originating Application, attach an extra page and indicate which

section is continued on the extra page. Filing Your Originating Application You must make 3 extra copies of your completed and signed Originating Application (including any additional document s). To file your Originating Application, you can either bring it to a Supreme Court location near you or you can mail it to a Supreme Court location near you (with the filing fee attached). You can look up the fees online: www.court.nl.ca/supreme/fees.html Serving Your Originating Application You must give a copy of th e Originating Application to the Respondent. This is called service.

You have 180 days to serve the Respondent after you have filed the Application. If you do not serve the Application in 180 days, it will expire and you may have to file a new Originating Application. If your Application involves divorce and/or parenting, an adult (who is not you) must hand-deliver the Application to the Respondent. This is called personal service. You will have to file an Affidavit of Service (Form F8.11A) with the Court.

If your Application does not involve divorce or parenting, you can serve the Respondent by personal service, leaving a copy with the Respondent’s lawyer, l eaving a copy at the Respondent’s address, registered mail/courier, or regular mail. You can also serve by fax, email, or e lectronic document exchange , if the Respondent has provided that information. You will have to file an Affidavit of Service (Form F8.11A), Acknowledgement o f Service (Form F8. 04A), a copy of the document with the recipient’s lawyer’s endorsement on it, a reply email, or a delivery confirmation with the Court.

More Information Questions? Go to www.court.nl.ca/supreme/family or contact a Court near you: Corner Brook: (709) 637-2227 Gander: (709) 256-1115 Grand Bank: (709) 832-1720 Grand Falls-Windsor: (709) 292-4260 Happy Valley-Goose Bay: (709) 896-7892 St.

John’s: (709) 729-2258 --- It is highly recommended that you get advice from a lawyer --- If you need help finding or getting a lawyer, you can contact: Public Legal Information Association of NL (PLIAN): www.publiclegalinfo.com or 1 (888) 660-7788 Legal Aid: www.legalaid.nl.ca or 1(800) 563-9911 --- REMOVE THIS PAGE BEFORE SERVING THE APPLICATION ON THE RESPONDENT --- 61 The Newfoundland and Labrador Gazette February 26, 2021

Form F4.03A: Originating Application (Family Law) – Instructions for the Respondent Supreme Court of Newfoundland and Labrador Rules of the Supreme Court, 1986 (March 2021) Page 1 of 1 How to Respond to an Originating Application Instructions for the Respondent A family law proceeding has been started against you. You are the Respondent in this proceeding. The person who has started this family law proceeding is the Applicant. Read the attached Originating Application (Form 4.03A) carefully. The Applicant has explained the family law issues that they would like to have resolved.

If you want to oppose any of the Applicant’s claims or if you want to make your own claims, you must file and serve a Response (Form F6.02A). You can get a Response form at any Supreme Court location or online: www.court.nl.ca/supreme/family/forms.html You have only 30 days after this Originating Application has been served on you to file and serve your Response (You have 60 days if you have been served outside of Canada or the United States). For more information on how to fill out, file, and serve a Response, read the “Instructions for the Respondent” page attached to the Response form.

If you do not respond, the Court may proceed and make an order without hearing from you. More Information Questions? You can go to www.court.nl.ca/supreme/family or contact a Court near you: Corner Brook: (709) 637-2227 Gander: (709) 256-1115 Grand Bank: (709) 832-1720 Grand Falls-Windsor: (709) 292-4260 Happy Valley-Goose Bay: (709) 896-7892 St.

John’s: (709) 729-2258 --- It is highly recommended that you get advice from a lawyer --- If you need help finding a lawyer, you can contact: Public Legal Information Association of NL (PLIAN): www.publiclegalinfo.com or 1 (888) 660-7788 Legal Aid: www.legalaid.nl.ca or 1(800) 563-9911 63 The Newfoundland and Labrador Gazette February 26, 2021

Form F4.03A – Originating Application (Family Law) Supreme Court of Newfoundland and Labrador Rules of the Supreme Court, 1986 (March 2021) Page 1 Form F4.03A: Originating Application (Family Law) In the Supreme Court of Newfoundland and Labrador (General/Family) FOR COURT USE ONLY COURT FILE NO: CENTRAL DIVORCE REGISTRY NO: Filed at _____________________________ , Newfoundland and Labrador, this ________ day of __________________, 20______.

Registry Clerk of the Supreme Court of Newfoundland and Labrador BETWEEN: APPLICANT (Print full name) AND: RESPONDENT (Print full name) AND:  NOT APPLICABLE  SECOND APPLICANT  SECOND RESPONDENT (Print full name) You must start your application at the Court location that is closest to you or closest to the other party. However, if your family law matter involves parenting or child support, you must start your application at the Court location that is closest to where your children live.

Check off where your application is required to be heard and note the location where you must file your documents: If your application is required to be heard in… …then you must file your documents in…  Clarenville (Grand Bank Circuit) Grand Bank Supreme Court  Corner Brook Corner Brook Supreme (Family Division)  Gander Gander Supreme Court  Grand Bank Grand Bank Supreme Court  Grand Falls – Windsor Grand Falls – Windsor Supreme Court  Happy Valley – Goose Bay Happy Valley – Goose Bay Supreme Court  Port aux Basques (Corner Brook Circuit) Corner Brook Supreme Court (Family Division)  Rocky Harbour (Corner Brook Circuit) Corner Brook Supreme Court (Family Division)  St.

Anthony (Corner Brook Circuit) Corner Brook Supreme Court (Family Division)  St. John’s St. John’s Supreme Court (Family Division)  Stephenville (Corner Brook Circuit) Corner Brook Supreme Court (Family Division)  Wabush (Happy Valley – Goose Bay Circuit) Happy Valley – Goose Bay Supreme Court 65 The Newfoundland and Labrador Gazette February 26, 2021

Form F4.03A – Originating Application (Family Law) Supreme Court of Newfoundland and Labrador Rules of the Supreme Court, 1986 (March 2021) Page 2 Check the type of order(

s) that you are seeking: You must fill out the Schedule(

s) that relate to your claim(

s) and attach any additional forms or documents required. Type of Order Fill Out

Schedule Attach  Divorce 1 Original marriage certificate  Parenting (Decision-making and parenting time) 2 -  Contact Order / Third Party Time with Child* 3 -  Child Support 4 Financial Statement (Form F10.02A) and/or income information, if applicable  Spousal (married) Support or Partner (unmarried) Support 5 Financial Statement (Form F10.02A)  Parental Support (for parents) or Dependant Support (for spouse or child of deceased person) 5 Financial Statement (Form F10.02A)  Division of Matrimonial (married) Property, Common Law (unmarried) Property, or Property under the FHRMIR Act 6 Property Statement (Form F10.04A)  Return of Child (within Canada) 7 Emergency Interim Application (Form 17.03A) if applicable  Consent Order or Agreement 8 Signed consent order or agreement  Other: ___________________________________ 8 - *Under the Divorce Act, a judge’s permission is required to make an application for a Contact Order.

Once received, your application will first be considered by a judge to determine if it may proceed. 66 The Newfoundland and Labrador Gazette February 26, 2021

Form F4.03A – Originating Application (Family Law) Supreme Court of Newfoundland and Labrador Rules of the Supreme Court, 1986 (March 2021) Page 3 Applicant Information Fill in your information below. Note: If you have safety concerns and do not want to provide your contact information, you may provide alternate contact information below. You must still provide the Court with your actual contact information in a sealed envelope. This envelope will not be available to the other party.

Current Last Name Last Name at Birth: First Name Middle Name(s) (if any) Gender Residential Address Street Address City Province Postal Code Mailing Address (if different from Residential Address) Street Address or PO Box City Province Postal Code Telephone Number (if any) Home: Cell: Fax Number (if any) Email Address (if any) Please note that if you provide your email address, the Court may contact you by email. Date of Birth Month: Day: Year: Occupation(

s) or Job(

s) Citizen / Immigration Status  Canadian Citizen  Permanent Resident  Foreign National Are you a registered Indian under the Indian Act?  Yes  No If yes, what is the name of your band? Do you live on a reserve? Will you need an interpreter in court?*  Yes  No If yes, state the language and dialect: Lawyer’s Name, Telephone Number, and Address (if any) * Please note that you must arrange to have a qualified interpreter appear in court and you will be responsible for any fees associated with this, unless a judge orders otherwise. 67 The Newfoundland and Labrador Gazette February 26, 2021

Form F4.03A – Originating Application (Family Law) Supreme Court of Newfoundland and Labrador Rules of the Supreme Court, 1986 (March 2021) Page 4 Respondent Information Fill in the Respondent’s information below (to the best of your knowledge). Current Last Name Last Name at Birth: First Name Middle Name(s) (if any) Gender Residential Address Street Address City Province Postal Code Mailing Address (if different from Residential Address) Street Address or PO Box City Province Postal Code Telephone Number (if any) Home: Cell: Fax Number (if any) Email Address (if any) Date of Birth Month: Day: Year: Occupation(

s) or Job(

s) Citizen / Immigration Status  Canadian Citizen  Permanent Resident  Foreign National Is the Respondent a registered Indian under the Indian Act?  Yes  No If yes, what is the name of the Respondent’s band? Does the Respondent live on a reserve?

Lawyer’s Name, Telephone Number, and Address (if any) Fill in the information about your relationship with the Respondent: Your relationship with the Respondent Date the parties started living together Month: Day: Year: OR  Not applicable Date of marriage Month: Day: Year: OR  Not applicable Place of marriage OR  Not applicable Prior to the marriage, you were  Unmarried  Divorced  Widowed OR  Not applicable Prior to the marriage, the Respondent was  Unmarried  Divorced  Widowed OR  Not applicable Date of separation Month: Day: Year: OR  Not applicable Date of divorce Month: Day: Year: OR  Not applicable  Check this box if you are starting a proceeding against more than one Respondent.

Attach an extra page to provide the information of the other Respondent(

s) and the details of your relationship with the other Respondent(s). 68 The Newfoundland and Labrador Gazette February 26, 2021

Form F4.03A – Originating Application (Family Law) Supreme Court of Newfoundland and Labrador Rules of the Supreme Court, 1986 (March 2021) Page 5 Fill in the information for every child of your relationship (Include children under and over 19 and non-dependent children): Child 1 Child 2 Child’s Full Name Full Name of Each Parent of the Child (place each name on a separate line) Date of Birth (month/day/year) Gender Child is Currently Living With (Name) Disabilities and/or Special Needs Child 3 Child 4 Child’s Full Name Full Name of Each Parent of the Child (place each name on a separate line) Date of Birth (month/day/year) Gender Child is Currently Living With (Name) Disabilities and/or Special Needs  Check this box if there are no children.  Check this box if there are more than 4 children.

Attach an extra page to provide the details of those children. 69 The Newfoundland and Labrador Gazette February 26, 2021

Form F4.03A – Originating Application (Family Law) Supreme Court of Newfoundland and Labrador Rules of the Supreme Court, 1986 (March 2021) Page 6 Have child protection services, in this province or elsewhere, ever been involved with you, the Respondent (s), and/or any of the children listed above?  No  Yes. If yes, please provide details in the box below. Provide the details of any current or ongoing court proceedings, court orders, and/or written agreement s involving you, the Respondent(s), and/or the children.

This includes all Provincial Court matters, criminal matters, proceedings in other provinces or countries, peace bonds, emergency protection ord ers, restraining orders, no -contact orders, safety plans, family centered action plans, and kinship care agreements or any other agreements stemming from CSSD involvement.  Check this box if not applicable. 70 The Newfoundland and Labrador Gazette February 26, 2021

Form F4.03A – Originating Application (Family Law) Supreme Court of Newfoundland and Labrador Rules of the Supreme Court, 1986 (March 2021) Page 7 (Note: This

Schedule is intended for divorce applications under the Divorce Act. If you are seeking a divorce under the Civil Marriages Act, fill out

Schedule 7.)

Schedule 1 Divorce In order to apply for a divorce, you must be able to satisfy all 4 of the requirements below: 1  There has been a breakdown in our marriage and there is no likelihood that we will get back together. 2  I am a resident of Newfoundland and Labrador and have been a resident of Newfoundland and Labrador for at least 1 year immediately prior to this application.

OR  My spouse is a resident of Newfoundland and Labrador and has been a resident of Newfoundland and Labrador for at least 1 year immediately prior to this application. 3  I have attached the original Certificate of Marriage (or Registration of Marriage) to this Application. If you were married in Canada, you can obtain your Certificate of Marriage from the provincial Vital Statistics Agency.  Check this box if your Certificate of Marriage is not in English or French. You must attach a translation and an Affidavit from the translator.

OR  I was married outside of Canada and I am unable to attach a copy of my Certificate of Marriage (or Registration of Marriage) because it is impossible or impractical to obtain. You will have to make an Interim Application for a Procedural Order (using Form F16.03A) for an Order dispensing with the need to file a Certificate of Marriage. 4  There has been no collusion in relation to this application for a divorce.

I am seeking a divorce because there has been a permanent breakdown in our marriage based upon:  Separation: Check this box if you and your spouse currently live separate and apart and will have lived separate and apart for at least 1 year prior to the determination of the divorce proceeding. If you and your spouse have been living separate and apart for less than 1 year, you may still file an Originating Application for divorce on the ground of separation.

However, you must wait until 1 year has elapsed to file an Application for Judgment for divorce.  Adultery: Check this box if you are seeking divorce because the Respondent has committed adultery. Attach an extra page with details of the adultery. You may be required to present further evidence of the adultery. You do not need to name any other person involved. If you choose to name another person, you must serve this Originating Application on that person by personal service. That other person(

s) will have the same rights as the Respondent in relation to the adultery claim and may file a Response.  Check this box to declare that you have not condoned or connived in the adultery.  Cruelty: Check this box if you are seeking divorce because your spouse has treated you with physical or mental cruelty that makes continued cohabitation intolerable. Attach an extra page with details of the cruelty. You may be required to present further evidence of the physical or mental cruelty.  Check this box to declare that you have not condoned or connived in the cruelty. 71 The Newfoundland and Labrador Gazette February 26, 2021

Form F4.03A – Originating Application (Family Law) Supreme Court of Newfoundland and Labrador Rules of the Supreme Court, 1986 (March 2021) Page 8

Schedule 2 Parenting Order If you are making an application for a parenting order (decision-making and/or parenting time), or are a person looking to step into the role of parent, fill in the information below. What are the current parenting arrangements for: Decision-making about the child(ren): Regular parenting

schedule (daily, weekly, monthly, or other): Parenting

schedule for holidays and special occasions:

Schedule for other communication (ie. phone or internet): Other important issues in relation to parenting the child(ren): 72 The Newfoundland and Labrador Gazette February 26, 2021

Form F4.03A – Originating Application (Family Law) Supreme Court of Newfoundland and Labrador Rules of the Supreme Court, 1986 (March 2021) Page 9 What are your proposed parenting arrangements for: Decision-making about the child(ren): Regular parenting

schedule (daily, weekly, monthly, or other): Parenting

schedule for holidays and special occasions:

Schedule for other communication (eg. phone, internet, etc.): Other important issues in relation to parenting the child(ren): 73 The Newfoundland and Labrador Gazette February 26, 2021

Form F4.03A – Originating Application (Family Law) Supreme Court of Newfoundland and Labrador Rules of the Supreme Court, 1986 (March 2021) Page 10

Schedule 3 Contact Order/ Third Party Time with Child If you are a non-parent making an application for contact or time with a child, fill in the information below: What is your relationship to the child (i.e. grandparent, foster parent, step-parent, other relative): What contact/ time do you presently have or have you had with the child?: What contact/ time with the child are you seeking?: Are there any orders or other past or present proceedings or circumstance that may be relevant to your request for contact/ time with the child (i.e. previous convictions, involvement with child protection authorities)?: Other information that may be relevant to the court in determining whether to grant you contact/time with the child: 74 The Newfoundland and Labrador Gazette February 26, 2021

Form F4.03A – Originating Application (Family Law) Supreme Court of Newfoundland and Labrador Rules of the Supreme Court, 1986 (March 2021) Page 11

Schedule 4 Child Support Check all of the boxes that apply:  I am seeking the basic table amount as per the Child Support Guidelines.  I am seeking special and/or extraordinary expenses. You must complete and attach a Financial Statement (Form (F10.02A).  I am seeking an amount of child support that is different from the Child Support Guidelines basic table amount. Depending on your reason(

s) for seeking an amount different from the Child Support Guidelines, you may have to attach further documentation. List your reason(

s) for seeking an amount of child support different from the Child Support Guidelines:  The Respondent and I have agreed to child support in the amount of $ ______________ per month.  I have parenting time with the child(ren) for 40% or more of the year. You must complete and attach a Financial Statement (Form F10.02A).  The child(ren) is(are) 19 years of age or older. You must complete and attach a Financial Statement (Form F10.02A).  One or more of the persons who is obligated to pay support has an income that is more than $150,000 annually.

You must complete and attach a Financial Statement (Form F10.02A).  I am claiming undue hardship for the following reason(s): You must complete and attach a Financial Statement (Form F10.02A).  Other: Depending on your claim, you may be required to complete and attach a Financial Statement (Form F10.02A).  I am seeking retroactive child support. What is the amount of retroactive child support that you are seeking? $_______________________________ What is the date from which you are seeking retroactive child support? (month/day/year) ____________________ Describe the facts and your reason(

s) for seeking retroactive child support: 75 The Newfoundland and Labrador Gazette February 26, 2021

Form F4.03A – Originating Application (Family Law) Supreme Court of Newfoundland and Labrador Rules of the Supreme Court, 1986 (March 2021) Page 12

Schedule 5 Spousal, Partner, Parental, or Dependant Support If you are seeking spousal, partner, parental, or dependant support, you must complete and attach a Financial Statement (Form F10.02A) Check all of the boxes that apply and fill in the information required:  I am seeking :  Spousal support  Partner support  Parental support  Dependant support Describe the facts and your reason(

s) for seeking support:  I am seeking:  Retroactive spousal support  Retroactive partner support  Retroactive parental support  Retroactive dependant support What is the amount of retroactive support that you are seeking? $__________________________________ What is the date from which you are seeking retroactive support? (month/day/year) _______________________ Describe the facts and your reason(

s) for seeking retroactive support: 76 The Newfoundland and Labrador Gazette February 26, 2021

Form F4.03A – Originating Application (Family Law) Supreme Court of Newfoundland and Labrador Rules of the Supreme Court, 1986 (March 2021) Page 13

Schedule 6 Division of Property If you are seeking a division of matrimonial property or common law property, you must complete and attach a Property Statement (Form F10.04) Check all of the boxes that apply and fill in any information required:  I am seeking an equal division of matrimonial property.  I am seeking an unequal division of matrimonial property. Describe the facts and your reason(

s) for seeking an unequal division of property:  I am seeking exclusive possession of the matrimonial home. Describe the facts and your reason(

s) for seeking exclusive possession of the matrimonial home:  I am seeking a division of common law property. Describe your property claim, the facts, and your reason(

s) for seeking the claim:  I am making a claim under the Family Homes on Reserves and Matrimonial Interests or Rights Act. Describe your property claim, the facts, and your reason(

s) for seeking the claim:  Other: Describe your property claim, the facts, and your reason(

s) for seeking the claim: 77 The Newfoundland and Labrador Gazette February 26, 2021

Form F4.03A – Originating Application (Family Law) Supreme Court of Newfoundland and Labrador Rules of the Supreme Court, 1986 (March 2021) Page 14

Schedule 7 Return of Child (within Canada) If you are seeking a court order for the return of a child or children (within Canada), answer the questions below: You may provide any additional affidavit(

s) necessary. At what address does the child(ren) habitually (normally) live? Set out all of the available facts and information that you have relating to the whereabouts of the child(ren): Set out all the available facts and information that you have regarding the identity of the person that the child(ren) is/are presumed to be with: Set out your reasons for making the application: 78 The Newfoundland and Labrador Gazette February 26, 2021

Form F4.03A – Originating Application (Family Law) Supreme Court of Newfoundland and Labrador Rules of the Supreme Court, 1986 (March 2021) Page 15

Schedule 8 Other Applications If you are seeking a court order for something other than the claims requested in the other Schedules, state what you are seeking, describe the facts, and give reasons: 79 The Newfoundland and Labrador Gazette February 26, 2021

Form F4.03A – Originating Application (Family Law) Supreme Court of Newfoundland and Labrador Rules of the Supreme Court, 1986 (March 2021) Page 16 Statement of Truth You must swear or affirm that the facts and information that you have written in this Originating Application and the attached Schedule(

s) is the truth. You must swear or affirm and sign this Statement of Truth in front of a commissioner of oaths, notary public, justice of the peace, or lawyer. Court Registry staff are commissioners of oaths and you may sign this application at the Court when you file it. I declare the facts and information in this Originating Application are true to the best of my knowledge and belief. SWORN TO or AFFIRMED at _______________________, this _________ day of _________________ , 20_____ .

Signature of Applicant Signature of Person Authorized to Administer Oaths Lawyer’s Signature for Fee Waiver I am employed by the Newfoundland and Labrador Legal Aid Commission or a Newfoundland and Labrador government department under the Executive Council Act and I am the lawyer of record in this matter. Signature of Lawyer (if any) Print Name of Lawyer (if any) 80 The Newfoundland and Labrador Gazette February 26, 2021

Form F4.03A – Originating Application (Family Law) Supreme Court of Newfoundland and Labrador Rules of the Supreme Court, 1986 (March 2021) Page 17 Lawyer’s Certificate If you are applying for a divorce and you are represented by a lawyer, your lawyer must complete this certificate. If you are not applying for divorce or do not have a lawyer, you do not have to fill out this certificate. I, ____________________________________ , the Lawyer for ______________________________________ , (Print Lawyer’s Name) (Print Applicant’s Name) the Applicant, certify to this Court that I have complied with s.7.7 of the Divorce Act, which provides: 7.7

(1) Unless the circumstances of the case are of such a nature that it would clearly not be appropriate to do so, it is the duty of every legal adviser who undertakes to act on a spouse’s behalf in a divorce proceeding (

a) to draw to the attention of the spouse the provisions of this Act that have as their object the reconciliation of spouses; and (

b) to discuss with the spouse the possibility of the reconciliation of the spouses and to inform the spouse of the marriage counselling or guidance facilities known to the legal adviser that might be able to assist the spouses to achieve a reconciliation.

(2) It is also the duty of every legal adviser who undertakes to act on a person’s behalf in any proceeding under this Act (

a) to encourage the person to attempt to resolve the matters that may be the subject of an order under this Act through a family dispute resolution process, unless the circumstances of the case are of such a nature that it would clearly not be appropriate to do so; (

b) to inform the person of the family justice services known to the legal adviser that might assist the person (

i) in resolving the matters that may be the subject of an order under this Act, and (ii) in complying with any order or decision made under this Act; and (

c) to inform the person of the parties’ duties under this Act.

(3) Every document that formally commences a proceeding under this Act, or that responds to such a document, that is filed with a court by a legal adviser shall contain a statement by the legal adviser certifying that they have complied with this section. DATED at _________________________________, this __________ day of ____________________ , 20______ . Signature of Lawyer Address of Lawyer 81 The Newfoundland and Labrador Gazette February 26, 2021

Form F4.04A: Joint Originating Application – Instructions for Co-Applicants Supreme Court of Newfoundland and Labrador Rules of the Supreme Court, 1986 (March 2021) Page 1 of 1 How to Make a Joint Originating Application Instructions for Co-Applicants You may use a Joint Originating Application (Form F4.04A) if you and the other person(

s) consent to your family law issues and want to apply for a family law order together. If you and the other person(

s) disagree on any family law issues, you cannot use this form. Instead, you must do an Originating Application (Form F4.03A). Completing Your Joint Originating Application You can fill out this form by hand or you can download and fill out this form electronically at www.court.nl.ca/supreme/family/forms.html (If you fill out the form electronically, you must still print the form and file it with the Court). You must fill out all of the pages in this Joint Originating Application and attach an agreement or a Consent Order (Form F34.02A and/or F34.02B). If you need more space to fill out any

section of this Joint Originating Application, attach an extra page and indicate which

section is continued on the extra page. Filing Your Joint Originating Application You must make 2 extra copies of your completed and signed Joint Originating Application (including any attachments). File your original Joint Originating Application with the Court. To file your Joint Originating Application, you can either bring it to a Supreme Court location near you or you can mail it to a Supreme Court location near you.

Serving Your Joint Originating Application Since all of the Co-Applicants have signed the filed Joint Originating Application, you do NOT need to serve the Joint Originating Application on the other Co-Applicant(s). However, you should still make sure all the Co-Applicants have a copy of the Joint Originating Application and all attachments. More Information Questions? Go to www.court.nl.ca/supreme/family or contact a Court near you: Corner Brook: (709) 637-2227 Gander: (709) 256-1115 Grand Bank: (709) 832-1720 Grand Falls-Windsor: (709) 292-4260 Happy Valley-Goose Bay: (709) 896-7892 St.

John’s: (709) 729-2258 --- It is highly recommended that you get advice from a lawyer --- If you need help finding or getting a lawyer, you can contact: Public Legal Information Association of NL (PLIAN): www.publiclegalinfo.com or 1 (888) 660-7788 Legal Aid: www.legalaid.nl.ca or 1(800) 563-9911 83 The Newfoundland and Labrador Gazette February 26, 2021

Form F4.04A – Joint Originating Application (Family Law) Supreme Court of Newfoundland and Labrador Rules of the Supreme Court, 1986 (March 2021) Page 1 Form F4.04A: Joint Originating Application (Family Law) In the Supreme Court of Newfoundland and Labrador (General/Family) FOR COURT USE ONLY COURT FILE NO: CENTRAL DIVORCE REGISTRY NO: Filed at _____________________________ , Newfoundland and Labrador, this ________ day of __________________, 20______.

Registry Clerk of the Supreme Court of Newfoundland and Labrador BETWEEN: CO-APPLICANT (Print full name) AND: CO-APPLICANT (Print full name) AND:  NOT APPLICABLE  CO-APPLICANT (Print full name) You must start your application at the Court location that is closest to you or closest to the other party. However, if your family law matter involves parenting or child support, you must start your application at the Court location that is closest to where your children live.

Check off where your application is required to be heard and note the location where you must file your documents: If your application is required to be heard in… …then you must file your documents in…  Clarenville (Grand Bank Circuit) Grand Bank Supreme Court  Corner Brook Corner Brook Supreme (Family Division)  Gander Gander Supreme Court  Grand Bank Grand Bank Supreme Court  Grand Falls – Windsor Grand Falls – Windsor Supreme Court  Happy Valley – Goose Bay Happy Valley – Goose Bay Supreme Court  Port aux Basques (Corner Brook Circuit) Corner Brook Supreme Court (Family Division)  Rocky Harbour (Corner Brook Circuit) Corner Brook Supreme Court (Family Division)  St.

Anthony (Corner Brook Circuit) Corner Brook Supreme Court (Family Division)  St. John’s St. John’s Supreme Court (Family Division)  Stephenville (Corner Brook Circuit) Corner Brook Supreme Court (Family Division)  Wabush (Happy Valley – Goose Bay Circuit) Happy Valley – Goose Bay Supreme Court 85 The Newfoundland and Labrador Gazette February 26, 2021

Form F4.04A – Joint Originating Application (Family Law) Supreme Court of Newfoundland and Labrador Rules of the Supreme Court, 1986 (March 2021) Page 2 Check the type of order(

s) that you are seeking: You must fill out and file the Schedule(

s) and any additional documents that relate to your claim(s). Type of Order Fill Out

Schedule Attachment(s)  Divorce 1 Original marriage certificate  Parenting (Decision-making and parenting time) 2 Consent Order or agreement  Contact Order / Third Party Time with Child* 3 -  Child Support 4 Consent Order or agreement  Spousal (married) Support or Partner (unmarried) Support 5 Consent Order or agreement  Parental Support (for parents) or Dependant Support (for spouse or child of deceased person) 5 Consent Order or agreement  Division of Matrimonial (married) Property, Common Law (unmarried) Property, or Property under the FHRMIR Act 6 Consent Order or agreement  Other: ___________________________________ 7 Consent Order or agreement *Under the Divorce Act, a judge’s permission is required to make an application for a Contact Order.

Once received, your application will first be considered by a judge to determine if it may proceed. 86 The Newfoundland and Labrador Gazette February 26, 2021

Form F4.04A – Joint Originating Application (Family Law) Supreme Court of Newfoundland and Labrador Rules of the Supreme Court, 1986 (March 2021) Page 3 Fill in the information below for the first Co-Applicant: Current Last Name Last Name at Birth: First Name Middle Name(s) (if any) Gender Residential Address Street Address City Province Postal Code Mailing Address (if different from Residential Address) Street Address or PO Box City Province Postal Code Telephone Number (if any) Home: Cell: Fax Number (if any) Email Address (if any) Please note that if you provide your email address, the Court may contact you by email. Date of Birth Month: Day: Year: Occupation(

s) or Job(

s) Citizen / Immigration Status  Canadian Citizen  Permanent Resident  Foreign National Are you a registered Indian under the Indian Act?  Yes  No If yes, what is the name of your band? Do you live on a reserve? Will you need an interpreter in court?*  Yes  No If yes, state the language and dialect: Lawyer’s Name, Telephone Number, and Address (if any) * Please note that you must arrange to have a qualified interpreter appear in court and you will be responsible for any fees associated with this, unless a judge orders otherwise. 87 The Newfoundland and Labrador Gazette February 26, 2021

Form F4.04A – Joint Originating Application (Family Law) Supreme Court of Newfoundland and Labrador Rules of the Supreme Court, 1986 (March 2021) Page 4 Fill in the information below for the second Co-Applicant: Current Last Name Last Name at Birth: First Name Middle Name(s) (if any) Gender Residential Address Street Address City Province Postal Code Mailing Address (if different from Residential Address) Street Address or PO Box City Province Postal Code Telephone Number (if any) Home: Cell: Fax Number (if any) Email Address (if any) Please note that if you provide your email address, the Court may contact you by email. Date of Birth Month: Day: Year: Occupation(

s) or Job(

s) Citizen / Immigration Status  Canadian Citizen  Permanent Resident  Foreign National Are you a registered Indian under the Indian Act?  Yes  No If yes, what is the name of your band? Do you live on a reserve? Will you need an interpreter in court?*  Yes  No If yes, state the language and dialect: Lawyer’s Name, Telephone Number, and Address (if any) * Please note that you must arrange to have a qualified interpreter appear in court and you will be responsible for any fees associated with this, unless a judge orders otherwise.

Fill in the information about your relationship below: Relationship of the parties Date the parties started living together Month: Day: Year: OR  Not applicable Date of marriage Month: Day: Year: OR  Not applicable Place of marriage OR  Not applicable Prior to the marriage, the first Co-Applicant was  Unmarried  Divorced  Widowed OR  Not applicable Prior to the marriage, the second Co-Applicant was  Unmarried  Divorced  Widowed OR  Not applicable Date of separation Month: Day: Year: OR  Not applicable Date of divorce Month: Day: Year: OR  Not applicable  Check this box if there are more than 2 Co-Applicants.

Attach an extra page to provide the information of the other Co-Applicant(

s) and details of your relationship with the other Co-Applicant(s). 88 The Newfoundland and Labrador Gazette February 26, 2021

Form F4.04A – Joint Originating Application (Family Law) Supreme Court of Newfoundland and Labrador Rules of the Supreme Court, 1986 (March 2021) Page 5 Fill in the information for every child of your relationship (Include children under and over 19 and non -dependent children): Child 1 Child 2 Child’s Full Name Full Name of Each Parent of the Child (place each name on a separate line) Date of Birth (month/day/year) Gender Child is Currently Living With (Name) Disabilities and/or Special Needs Child 3 Child 4 Child’s Full Name Full Name of Each Parent of the Child (place each name on a separate line) Date of Birth (month/day/year) Gender Child is Currently Living With (Name) Disabilities and/or Special Needs  Check this box if there are no children.  Check this box if there are more than 4 children.

Attach an extra page to provide the details of those children. 89 The Newfoundland and Labrador Gazette February 26, 2021

Form F4.04A – Joint Originating Application (Family Law) Supreme Court of Newfoundland and Labrador Rules of the Supreme Court, 1986 (March 2021) Page 6 Have child protection services, in this province or elsewhere, ever been involved with any of the co-applicants and/or children listed above?  No  Yes. If yes, please provide details in the box below. Provide the details of any current or ongoing court proceedings, court orders, and/or written agreements involving any of the co-applicants and/or children.

This includes all Provincial Court matters, criminal matters, proceedings in other provinces or countries, peace bonds, emergency protection orders, restraining orders, no-contact orders, safety plans, family centered action plans, and kinship care agreements or any other agreements stemming from CSSD involvement.  Check this box if not applicable. 90 The Newfoundland and Labrador Gazette February 26, 2021

Form F4.04A – Joint Originating Application (Family Law) Supreme Court of Newfoundland and Labrador Rules of the Supreme Court, 1986 (March 2021) Page 7 (Note: This

Schedule is intended for divorce applications under the Divorce Act. If you are seeking a divorce under the Civil Marriages Act, fill out

Schedule 6.)

Schedule 1 Divorce In order to apply for a divorce, you must be able to satisfy all 4 of the requirements below: 1  There has been a breakdown in our marriage and there is no likelihood that we will get back together. 2  I am a resident of Newfoundland and Labrador and have been a resident of Newfoundland and Labrador for at least 1 year immediately prior to this application.

OR  My spouse is a resident of Newfoundland and Labrador and has been a resident of Newfoundland and Labrador for at least 1 year immediately prior to this application. 3  I have attached the original Certificate of Marriage (or Registration of Marriage) to this Application. If you were married in Canada, you can obtain your Certificate of Marriage from the provincial Vital Statistics Agency.  Check this box if your Certificate of Marriage is not in English or French. You must attach a translation and an Affidavit from the translator.

OR  I was married outside of Canada and I am unable to attach a copy of my Certificate of Marriage (or Registration of Marriage) because it is impossible or impractical to obtain. You will have to make an Interim Application for a Procedural Order (using Form F16.03A) for an Order dispensing with the need to file a Certificate of Marriage. 4  There has been no collusion in relation to this application for a divorce.

We are seeking a divorce because there has been a permanent breakdown in our marriage based upon separation:  Check this box if the parties currently live separate and apart and will have lived separate and apart for at least 1 year prior to the determination of the divorce proceeding. If the parties have been living separate and apart for less tha n 1 year, you may still file an Application for divorce on the ground of separation. However, you must wait until 1 year has elapsed to file an Application for Judgment for divorce.

Check the box that applies to you and fill out any information needed:  There are no children of the marriage OR  Reasonable arrangements have been made for the support of the children (Give details and include your annual incomes): 91 The Newfoundland and Labrador Gazette February 26, 2021

Form F4.04A – Joint Originating Application (Family Law) Supreme Court of Newfoundland and Labrador Rules of the Supreme Court, 1986 (March 2021) Page 8

Schedule 2 Parenting Order If you are making an application for a parenting order (decision-making and/or parenting time), or are a person looking to step into the role of parent, fill in the information below. What are the current parenting arrangements for: Decision-making about the child(ren): Regular parenting

schedule (daily, weekly, monthly, or other): Parenting

schedule for holidays and special occasions:

Schedule for other communication (ie. phone or internet): Other important issues in relation to parenting the child(ren): 92 The Newfoundland and Labrador Gazette February 26, 2021

Form F4.04A – Joint Originating Application (Family Law) Supreme Court of Newfoundland and Labrador Rules of the Supreme Court, 1986 (March 2021) Page 9 What are your proposed parenting arrangements for: Decision-making about the child(ren): Regular parenting

schedule (daily, weekly, monthly, or other): Parenting

schedule for holidays and special occasions:

Schedule for other communication (eg. phone, internet, etc.): Other important issues in relation to parenting the child(ren): 93 The Newfoundland and Labrador Gazette February 26, 2021

Form F4.04A – Joint Originating Application (Family Law) Supreme Court of Newfoundland and Labrador Rules of the Supreme Court, 1986 (March 2021) Page 10

Schedule 3 Contact Order/ Third Party Time with Child If you are a non-parent making an application for contact or time with a child, fill in the information below: What is your relationship to the child (i.e. grandparent, foster parent, step-parent, other relative): What contact/ time do you presently have or have you had with the child?: What contact/ time with the child are you seeking?: Are there any orders or other past or present proceedings or circumstance that may be relevant to your request for contact/ time with the child (i.e. previous convictions, involvement with child protection authorities)?: Other information that may be relevant to the court in determining whether to grant you contact/time with the child: 94 The Newfoundland and Labrador Gazette February 26, 2021

Form F4.04A – Joint Originating Application (Family Law) Supreme Court of Newfoundland and Labrador Rules of the Supreme Court, 1986 (March 2021) Page 11

Schedule 4 Child Support Check all of the boxes that apply:  We agree to the basic table amount as per the Child Support Guidelines.  We agree on special and/or extraordinary expenses.  We agree to an amount of child support that is different from the Child Support Guidelines basic table amount. What are your incomes? Co-Applicant 1’s Annual Income: $ Co-Applicant 2’s Annual Income: $ What are your reason(

s) for an amount of child support that is different from the Child Support Guidelines?  We agree to child support in the amount of $ _____________________________ per month.  Each of us has parenting time with the child(ren) for 40% or more of the year.  The child(ren) is(are) 19 years of age or older.  One or more of the persons who is obligated to pay support has an income that is more than $150,000 annually.  One or more of us is claiming undue hardship for the following reason(s):  Other:  We agree to an amount of retroactive child support. Describe the reason(

s) for retroactive child support: 95 The Newfoundland and Labrador Gazette February 26, 2021

Form F4.04A – Joint Originating Application (Family Law) Supreme Court of Newfoundland and Labrador Rules of the Supreme Court, 1986 (March 2021) Page 12

Schedule 5 Spousal, Partner, Parental, or Dependent Support Check all of the boxes that apply and fill in the information required:  We have agreed to an amount of :  Spousal support  Partner support  Parental support  Dependent support Describe the reason(

s) for support:  We have agreed to an amount of:  Retroactive spousal support  Retroactive partner support  Retroactive parental support  Retroactive dependent support Describe the reason(

s) for retroactive support: 96 The Newfoundland and Labrador Gazette February 26, 2021

Form F4.04A – Joint Originating Application (Family Law) Supreme Court of Newfoundland and Labrador Rules of the Supreme Court, 1986 (March 2021) Page 13

Schedule 6 Division of Property Check all of the boxes that apply and fill in any information required:  We agree to an equal division of matrimonial property.  We agree to an unequal division of matrimonial property. Describe the reason(

s) for an unequal division of property:  We agree to a division of common law property. Describe the property claim and the reason(

s) for the property claim:  We agree to a division of property under the Family Homes on Reserves and Matrimonial Interests or Rights Act. Describe your property claim, the facts, and your reason(

s) for seeking the claim:  Other: Describe the property claim and the reason(

s) for the property claim: 97 The Newfoundland and Labrador Gazette February 26, 2021

Form F4.04A – Joint Originating Application (Family Law) Supreme Court of Newfoundland and Labrador Rules of the Supreme Court, 1986 (March 2021) Page 14

Schedule 7 Other Applications If you have come to an agreement on something other than the claims listed in the other Schedules, state what you are agreeing to and give reasons: 98 The Newfoundland and Labrador Gazette February 26, 2021

Form F4.04A – Joint Originating Application (Family Law) Supreme Court of Newfoundland and Labrador Rules of the Supreme Court, 1986 (March 2021) Page 15 If there are more than 2 Co-Applicants, attach an extra page with the signatures required below. Statement of Truth All Co-Applicants must swear or affirm that the facts and information in this Application, the attached schedules, and the attached Consent Order(

s) is the truth. You must swear or affirm and sign this Statement of Truth in front of a commissioner of oaths, notary public, justice of the peace, or lawyer. Court Registry staff are commissioners of oaths and you may sign this application at the Court when you file it. First Co-Applicant Second Co-Applicant I declare the facts and information in this Joint Originating Application are true to the best of my knowledge and belief. I declare the facts and information in this Joint Originating Application are true to the best of my knowledge and belief.

SWORN TO or AFFIRMED at ___________________, this ________ day of _________________ , 20_____ . SWORN TO or AFFIRMED at ___________________, this ________ day of _________________ , 20_____ . Signature of First Co-Applicant Signature of Second Co-Applicant Commissioner of Oaths / Justice of the Peace Commissioner of Oaths / Justice of the Peace 99 The Newfoundland and Labrador Gazette February 26, 2021

Form F4.04A – Joint Originating Application (Family Law) Supreme Court of Newfoundland and Labrador Rules of the Supreme Court, 1986 (March 2021) Page 16 Lawyer’s Certificate If any of the Co -Applicants has a lawyer and you have applied for a divorce, yo ur lawyer(

s) must complete the Certificate(

s) below. If you are not applying for divorce or none of the Co-Applicants has a lawyer, you do not need to fill out this section. First Co-Applicant’s Lawyer I, ____________________________________ , the Lawyer for ______________________________________ , (Print Lawyer’s Name) (Print Co-Applicant’s Name) the Applicant, certify to this Court that I have complied with s.7.7 of the Divorce Act, which provides: 7.7