Word Version The term “counsel” includes any person who acts in a proceeding on behalf of a party. More than one counsel from the same firm or government institution acting for the same party can be listed on this form. All references below to the singular include the plural, where applicable. File number Subject matter Notice is given that I will appear as counsel of record for (name of person, company, foreign government or Canadian government institution), a party before the Tribunal in the above-referenced matter. Counsel of record information Counsel info Counsel info Counsel info Name of counsel Name of firm or government institution Address City and province Postal code Telephone Email Add counsel Each counsel listed on this form understands that the checking of this box constitutes their legally binding signature. If more than one counsel is listed on the form, each counsel has authorized to check this box and file this form with the Tribunal on their behalf. The signatory must be one of the counsel listed. This box must be checked for the form to be considered complete. Dated at Location on Date Print