FORM 76P

REQUEST FOR APPOINTMENT OF LITIGATION GUARDIAN

File No.

THE KING'S BENCH

Centre

BETWEEN:

claimant

- and -

defendant

REQUEST FOR APPOINTMENT OF LITIGATION GUARDIAN

I, [name of claimant or other person] , request that a litigation guardian for [name] , the defendant in this claim, be appointed because [name] is:

(check one)

[ ]	a minor, whose date of birth is [ day/month/year ]

[ ]	mentally incompetent or incapable of managing his or her affairs, not so declared.

[Give details as to nature and extent of disability.]

I am not aware of a committee or a substitute decision maker being appointed for the defendant.

Date

Signature

Address and postal code