FORM 72C

AFFIDAVIT OF EXECUTION OF BOND

THE KING'S BENCH

Centre

[Title of Proceeding]

AFFIDAVIT OF EXECUTION OF BOND

I, [name of witness] , of the of in the Province of Manitoba, [occupation] , make oath and say:

1.	I was present and did see the bond, a true copy of which is attached and marked as Exhibit "A" to this affidavit, signed and sealed by [names of parties] , the parties named in the attached bond as sureties.

2.	I know the parties named in the attached bond and that they are each of the full age of eighteen years.

3.	The attached bond was signed and sealed on [date] at the of in the Province of Manitoba by the persons named in the bond as sureties.

4.	I signed the attached bond as a witness to the signatures of the persons named in the bond as sureties.

SWORN before me, at the	)

of in the Province of	)	[signature of affiant]

Manitoba, this day , 19 :	)

[signature] ,	)

a in	)

and for the Province of Manitoba.	)