Complete and file this form, together with the documents required by Part V of this form, with the Clerk of Court. When stating an amount of money, identify the currency in which the amount is stated.

PART I. IDENTIFICATION OF CANADIAN JUDGMENT

Canadian Court Rendering the Judgment: _________________________________________

Case/Docket Number in Canadian Court: _________________________________________

Name of Plaintiff(s): _________________________________________

Name of Defendant(s): _________________________________________

The Canadian Court entered the judgment on ______ [date] in ________ [city] ________ [Province or Territory]. The judgment includes an award for the payment of money in favor of ________ in the amount of ________ . If only part of the Canadian judgment is subject to registration (see § 9-35-3(b) and (c)), describe the part of the judgment being registered:

_________________________________________

PART II. IDENTIFICATION OF PERSON REGISTERING JUDGMENT AND PERSON AGAINST WHOM JUDGMENT IS BEING REGISTERED

Provide the following information for all persons seeking to register the judgment under this registration and all persons against whom the judgment is being registered under this registration.

Name of Person(s) Registering Judgment: _________________________________________

If a person registering the judgment is not the person in whose favor the judgment was rendered, describe the interest the person registering the judgment has in the judgment which entitles the person to seek its recognition and enforcement:

_________________________________________

Address of Person(s) Registering Judgment:

_________________________________________

Additional Contact Information for Person(s) Registering Judgment (Optional):

Telephone Number: ______ FAX Number: ______

Email Address: _________________________________________

Name of Attorney for Person(s) Registering Judgment, if any: _________________________________________

_________________________________________

Address: _________________________________________

Telephone Number: ______ FAX Number: ______

Email Address: _________________________________________

Name of Person(s) Against Whom Judgment is Being Registered:

_________________________________________

Address of Person(s) Against Whom Judgment is Being Registered:

_________________________________________
_________________________________________ (provide the most recent address known)

Additional Contact Information for Person(s) Against Whom Judgment is Being Registered (Optional) (provide most recent information known):

Telephone Number: ______ FAX Number: ______

Email Address: _________________________________________

PART III. CALCULATION OF AMOUNT FOR WHICH ENFORCEMENT IS SOUGHT

Identify the currency or currencies in which each amount is stated.

The amount of the Canadian judgment or part of the judgment being registered is: _________________________________________ .

The amount of interest accrued as of the date of registration on the part of the judgment being registered is _________________________________________

The applicable rate of interest is _________________________________________

The date when interest began to accrue is _________________________________________

The part of the judgment to which the interest applies is _________________________________________ .

The Canadian court awarded costs and expenses relating to the part of the judgment being registered in the amount of ________ (exclude any amount included in the award of costs and expenses which represents an award of attorneys’ fees).

The Canadian court awarded attorneys’ fees relating to the part of the judgment being registered in the amount of _________________________________________ .

The person registering the Canadian judgment claims post-judgment costs and expenses in the amount of ________ and post-judgment attorneys’ fees in the amount of ________ relating to the part of the judgment being registered (include only costs, expenses, and attorney’s fees incurred before registration).

The amount of the part of the judgment being registered which has been satisfied as of the date of registration is _________________________________________ .

The total amount for which enforcement of the part of the judgment being registered is sought is _________________________________________ .

PART IV. STATEMENT OF PERSON REGISTERING JUDGMENT

I, _________________________________________ state:

[Person Registering Judgment or Attorney for Person Registering Judgment]

1. The Canadian judgment is final, conclusive, and enforceable under the law of the Canadian jurisdiction in which it was rendered.

2. The Canadian judgment or part of the judgment being registered is within the scope of chapter 35 of Title 9 of the Rhode Island General Laws.

3. If only a part of the Canadian judgment is being registered, the amounts stated in Part III of this form relate to that part.

PART V. ITEMS REQUIRED TO BE INCLUDED WITH REGISTRATION

Attached are (check to signify required items are included):

____ A copy of the Canadian judgment authenticated in the same manner a copy of a foreign judgment is authenticated in an action under § 9-34-6 as an accurate copy by the Canadian court that entered the judgment.

____ If the Canadian judgment is not in English, a certified translation of the judgment into English.

____ A registration fee in the amount of one hundred sixty dollars ($160).

I declare that the information provided on this form is true and correct to the best of my knowledge and belief.

Submitted by:

_________________________________________

Signature of [Person Registering Judgment]

[Attorney for Person Registering Judgment]

[specify whether signer is the person registering the judgment or that person’s attorney]

Date of submission: _________________________________________