ONTARIO. | |. |. |. |Court File Number. | |. |. |. |SC-

ONTARIO
Superior Court of Justice
Court File Number
SC-00-12345-19.
(Name of court)
Form 6B: Affidavit of Service
sworn/affirmedat
74 Woolwich St, Guelph, ON N1H 3T9, Canada
Court office address
Applicant(s)
Full legal name & address for service — street & number, municipality,
postal code, telephone & fax numbers and e-mail address (if any).
Lawyer’s name & address — street & number, municipality, postal
code, telephone & fax numbers and e-mail address (if any).
Manuel Lopez
3492 Fallingbrook Crescent, Brampton, Ontario L1L
3L3
(Name of the student)
7899 McLaughlin Road, Brampton, Ontario L6Y 5H9,
tel [phone], LSO# P12345
Respondent(s)
Full legal name & address for service — street & number, municipality,
postal code, telephone & fax numbers and e-mail address (if any).
Lawyer’s name & address — street & number, municipality, postal
code, telephone & fax numbers and e-mail address (if any).
Anna Johnstone
593 Springbank Avenue, suite 1610, Toronto, Ontario
M1M 2M2
N/A
My name is (full legal name) Stanley Kostas
I live in (municipality & province) Toronto
and I swear/affirm that the following is true:
1. On (date) February 13, 2020 , at (time) N/A , I served (name of person to be served)
Anna Johnstone with the following document(s) in this case:
Name of document Author (if applicable) Date when document
signed, issued, sworn, etc.
List the
documents
served
Plaintiff’s Claim December 20, 2019
NOTE: You can leave out any part of this form that is not applicable.
2. I served the documents mentioned in paragraph 1 by:
Check one
box only and
go to
indicated
paragraph.
special service. (Go to paragraph 3 below if you used special service.)
mail. (Go to paragraph 4 if you used mailed service.)
same day courier. (Go to paragraph 5 if you used courier.)
next day courier. (Go to paragraph 5 if you used courier.)
deposit at a document exchange. (Go to paragraph 6 if you used a document exchange.)
an electronic document exchange. (Go to paragraph 7 if you used an electronic document exchange.)
fax. (Go to paragraph 8 if you used fax.)
email. (Go to paragraph 9 if you used email.)
substituted service or advertisement. (Go to paragraph 10 if you used substituted service or advertisement.)
FLR 6B (April 12, 2016) Page 1 of 3

Form 6B: Affidavit of Service (page 2) Court File Number
SC-00-12345-19.sworn/affirmed
3. I carried out special service of the document(s) on the person named in paragraph 1 at (place or address)
593 Springbank Avenue, suite 1610, Toronto, Ontario M1M 2M2
by: leaving a copy with the person.
Check one
box only.
Strike out
paragraphs 4
to 10 and go
to paragraph
11.
leaving a copy with (name)
who is a lawyer who accepted service in writing on a copy of the document.
who is the person’s lawyer of record.
who is the (office or position)
of the corporation named in paragraph 1.
mailing a copy to the person together with a prepaid return postcard in Form 6 in an envelope bearing
the sender’s return address. This postcard, in which receipt of the document(s) is acknowledged, was
returned and is attached to this affidavit.
leaving a copy in a sealed envelope addressed to the person at the person’s place of residence with
(name)
who provided me with identification to show that he/she was an adult person residing at the same
address and by mailing another copy of the same document(s) on the same or following day to the
person named in paragraph 1 at that place of residence.
other (Specify. See rule 6 for details.)
4. I mailed the document(s) to be served by addressing the covering envelope to the person named in paragraph 1 at:
(Set out address.) 593 Springbank Avenue, suite 1610, Toronto, Ontario M1M 2M2
which is the address of the person’s place of business.
Check appropriate
paragraph and strike
out paragraphs 3, 5, 6,
7, 8, 9 and 10.
of a lawyer who accepted service on the person’s behalf.
of the person’s lawyer of record.
of the person’s home.
on the document most recently filed in court by the person.
other (Specify.)
5. The document(s) to be served was/were placed in an envelope that was picked up at N/A a.m./p.m. on
(date) N/A by (name of courier service) N/A
a private courier service, a copy of whose receipt is attached to this affidavit. The envelope was addressed to the person
named in paragraph 1 at: (Set out address.) 593 Springbank Avenue, suite 1610, Toronto, Ontario M1M 2M2
which is the address of the person’s place of business.
Check appropriate
paragraph and strike
out paragraphs 3, 4, 6,
7, 8, 9 and 10.
of a lawyer who accepted service on the person’s behalf.
of the person’s lawyer of record.
of the person’s home.
on the document most recently filed in court by the person.
other (Specify.)
FLR 6B (April 12, 2016) Page 2 of 3

Form 6B: Affidavit of Service (page 3) Court File Number
SC-00-12345-19.sworn/affirmed
6. The document(s) was/were deposited at a document exchange. The exchange’s date stamp on the attached
copy shows the date of deposit. (Strike out paragraphs 3, 4, 5, 7, 8, 9, 10 and 13.)
7. The documents were served through an electronic document exchange. The record of service from the exchange
is attached to this affidavit. (Strike out paragraphs 3, 4, 5, 6, 8, 9, 10 and 13.)
8. The document(s) to be served was/were faxed. The fax confirmation is attached to this affidavit. (Strike out
paragraphs 3, 4, 5, 6, 7, 9, 10 and 13.)
9. The documents were served by email. Attached to this Affidavit is a copy of the email that the document was
attached to. (Strike out paragraphs 3, 4, 5, 6, 7, 8, 10 and 13.)
10. An order of this court made on (date) December 20, 2019 allowed
substituted service.
service by advertisement. (Attach advertisement.)
The order was carried out as follows: (Give details. Then go to paragraph 13 if you had to travel to serve substitutionally or
by advertisement.)
11. My relationship to, or affiliation with, any party in this case is as follows:
Process server of the lawyer of Anna Johnstone
12. I am at least 18 years of age.
13. To serve the document(s), I had to travel N/A kilometres. My fee for service of the document(s) is
$ N/A including travel.
Sworn/Affirmed before me at Brampton
municipality
in Ontario, Canada
province, state, or country
on February 13, 2020 Signature
(This form is to be signed in front
of a lawyer, justice of the peace,
notary public or commissioner
for taking affidavits.)
date Commissioner for taking affidavits
(Type or print name below if
signature is illegible.)
FLR 6B (April 12, 2016) Page 3 of 3