Form COSTS 3 Notice of Dissatisfaction (Costs)

Case Details

Court / Division*

[select court/division]

[First] Claimant*

[full name]

[Second Claimant] [number of Claimants (if more than two)]

[#full name #number]

Filed for*

[name e.g., Receiving or Paying Party]

Representation*

[select representation type]

Provisional assessment*

[date of issue and details of provisional assessment]

[attach a copy of the provisional assessment]

Assessment Officer*

[name]

Signature of legal representative

_____________________________________

Signature of [Receiving Party] [Paying Party] 

(if not legally represented)

_____________________________________