1863 R 1971 TS 1971 RF
ADDRESS OF DWELLING IN QUESTION
Complete in block letters and press hard
Monthly rent
Indeterminate term
DESCRIPTION OF THE PARTIES
Lessor Lessee Other (specify)
Lessor Lessee Other (specify)
Lessor Lessee Other (specify)
Lessor Lessee Other (specify)
OBJECT OF THE APPLICATION (conclusion sought)
Resiliation of the lease and eviction of the lessee
Other object
Recovery of rent due at the time of the hearing
(specify):
Order against the defendants jointly and severally
Interest and the additional indemnity provided for in the Civil Code
Payment of costs
Provisional execution of the decision notwithstanding appeal
GROUNDS OF THE APPLICATION
The rent has not been paid for the following period(s):
The lessee has delayed payment of the rent for more than three weeks.
The lessee is frequently late in paying the rent, thereby causing serious injury to the plaintiff.
Other (specify):
Application signed on:
Lawyer
Information clerk code
Annex attached to add additional information
Régie du logement RDL-065A-E (18-05)
Year
Month
Day
Print
Signature
Year
Month
Date of filing
Print
Signature
Postal code
Municipality
Postal code
Municipality
Postal code
Email address
Fax No.
Email address
Street
First name
Last name
No.
Street
Apt.
Defendant 1
Month
Day
Record No.
Application No.
Recourse code
Defendant 2
Last name
First name
No.
No.
Street
Plaintiff 2
Apt.
Home telephone No.
Work telephone No.
Fax No.
Municipality
Postal code
Municipality
$
$
Email address
$
Home telephone No.
Work telephone No.
Fax No.
Email address
Apt.
Home telephone No.
Work telephone No.
Fax No.
No.
Street
Apt.
Last name
First name
Home telephone No.
Work telephone No.
Application regarding unpaid rent
Last name
No.
Street
Apt.
Plaintiff 1
First name
Municipality
Postal code
Month
Day
Year
Beginning of lease
Year
End of lease
$
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I hereby discontinue the present application.
We, the undersigned, have signed an agreement attached hereto. agree as follows:
Following this agreement,
I request that the file be suspended.
Information clerk code
Signature - Plaintiff 2
Year
Month
Day
Year
Month
Day
Signature - Plaintiff 1
Date of filing
At the demand of either party, the proceedings at the Régie may be started up again.
The filing of the agreement closes the file at the Régie,
unless the plaintiff requests that it be suspended (see below).
INFORMATION REGARDING NOTIFICATION
DISCONTINUANCE
AGREEMENT
The discontinuance entails closing of the Régie file.
Where the parties reach an agreement, the board closes the case record upon the filing of a copy of the agreement signed by
the parties unless the party who filed the application or application files a written request to have the case suspended.
Thereafter, the case will only be placed on the roll upon the written request of a party.
Where an agreement is made or filed at the hearing and signed by the parties, the commissioner may ratify the agreement in
the form of a decision (Rules of procedures of the Régie du logement , art. 14).
Day
Signature - Plaintiff 1
Signature - Plaintiff 2
Year
Day
Month
Year
Month
Year
Month
Day
Signature - Plaintiff 2
Month
Day
Signature - Defendant 2
Year
Signature - Defendant 1
After filing an application at the Régie, the plaintiff must notify it upon the other party as soon as possible. The
plaintiff must establish at the hearing, to the satisfaction of the commissioner, that the other party has received a
copy of the application.
The plaintiff may notify the application by registered mail or by bailiff. He may also avail himself of any other means which
permits proof of receipt of the application. He may, for example, deliver a copy by hand.
If the commissioner is not satisfied with the proof of notification made at the hearing by the plaintiff, he may require that
the application be notified again.
If the plaintiff is unable to effect notification in the above fashion, a commissioner may, at any time upon motion, authorize
another means of notification. If such be the case, please consult one of the clerks of the Régie.
Signature - Plaintiff 1
Day
Month
Year
Year
Month
Day
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