Statement of Account

Criminal
Yes
No
Date prepared
(D / M / Y)


GST Registration No.



No. File Records



Period
From
(D / M / Y)

To
(D / M / Y)

Firm Name

Firm Vendor No.

Address



City
(D / M / Y)

Province


Postal Code


Telephone No.


Fax No.


Files Reported
Billing No. File Name Amount Rendered
Total Payment  
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     

I hereby certify that the services herein referred to were rendered by me or the member of the firm identified herein and this account truly shows the nature of the services rendered, the time occupied, the fees claimed, the disbursements made and all moneys received in this matter.

Agent

Signature

Date

Reviewed by (Police enforcement Agency or Client Department Official or Justice Legal Officer)

Name (Please print)

Signature

Telephone

Date

================Office use only=============================================

Client Department

Ref. No.

Verified by

Date

Entered by

Date

Jus 488 (2007/01)

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