FORM 16A

ACKNOWLEDGMENT OF RECEIPT FORM

(General Heading — Form 4A or 4B)

TO:	(full name)

You are served by mail with the documents enclosed with this form in accordance with the King's Bench Rules.

You are requested to sign the acknowledgment below and mail this form immediately after you receive it. If you fail to do so, the documents may be served on you in another manner and you may have to pay the costs of service.

ACKNOWLEDGMENT OF RECEIPT

I ACKNOWLEDGE that I have received a copy of the following documents: (To be completed in advance by the sender of the documents. Include sufficient particulars to identify each document).

(signature of person served).

(The reverse side of this form must bear the name and address of the sender and the required postage).