Application for Leave and Notice of Application

Tribunal File No.

SPECIFIC CLAIMS TRIBUNAL

BETWEEN:

Name of First Nation(s)

Claimant(s)

and

HER MAJESTY THE QUEEN IN RIGHT OF CANADA
As represented by the Minister of Crown-Indigenous Relations

Respondent

Pursuant to Part 4 of the Specific Claims Tribunal Rules of Practice and Procedure and Paragraph 13(1)(a) of the Specific Claims Tribunal Act

This Application for Leave and Notice of Application is filed under the provisions of the Specific Claims Tribunal Act, SC 2008, c 22, and the Specific Claims Tribunal Rules of Practice and Procedure, SOR/2011-119.

TO:

Name of opposing party

As represented by

Address of counsel

Telephone number of counsel

Fax number of counsel

Email address of counsel

TAKE NOTICE THAT an Application will be made on behalf of the

, before the Specific Claims Tribunal pursuant to Part 4 of the Specific Claims Tribunal Rules of Practice and Procedure, SOR/2011-119, to …

I. RELIEF SOUGHT

[1]

II. GROUNDS

[2]

III. CONSENT

[3]

Dated this

___________________________________
Counsel signature

Name of counsel

Counsel for the

Address of counsel

Email of counsel

Telephone number of counsel

Fax number of counsel