Document ID: chunk:federal_register_of_legislation:F2016C00720:schedule:1:p3
Version: federal_register_of_legislation:F2016C00720
Segment Type: schedule
Provision Reference: sch 1 (pt 3/12)
Character Range: 71564–74300

am the 2.

2. The respondent, 3, is 4,5.

3. On 6, 7.

4. I claim to be entitled to limit my liability arising out of these circumstances on the following grounds:              8

5. I therefore seek the following orders: 9

1. insert name and address of applicant
2. insert relationship of applicant with ship and specify name and port of registry of  ship
3. insert name and address of respondent
4. set out the relationship of the defendant with the circumstances out of which the  liability in respect of which the applicant claims to be entitled to limit liability               arose
5. repeat paragraph 2 for each defendant named as defendant, numbering the  paragraphs 2A, 2B, etc.
6. insert date of circumstances out of which the liability in respect of which the  applicant claims to be entitled to limit liability arose
7. give short, factual description of circumstances out of which the liability in  respect of which the applicant claims to be entitlied to limit liability arose
8. set out short statement of grounds for limiting liability
9. set out precise orders sought

Form 8—Statement of claim: action in rem
(subrule 22(2))
(Title)

STATEMENT OF CLAIM: ACTION IN REM

 1. 1

 2. I claim the following relief: 2

 PARTICULARS 3:

TO THE DEFENDANT:

If you want to defend this claim, you must, within 21 days after this statement of claim is served on you, file an appearance.

You may also pay an amount into court.

1. set out the facts giving rise to the claim; do not refer to evidence; the matter  should be put into paragraphs, numbered consecutively and set out as briefly as               convenient; unduly long pleadings may be penalised by costs
2. set out precisely the relief or orders sought
3. set out particulars of any injuries suffered

Form 9—Appearance
(subrule 23(2))
(Title)

APPEARANCE

 1. 1appears.

 2. My relationship with the ship/property2 against which this proceeding has been commenced is as follows:              3

 3. My address for service is: 4

1. insert name
2. strike out whichever is not applicable
3. insert short particulars of relationship
4. insert address for service

Form 10—Preliminary act
(paragraph 25(2)(a))

(Title)

PRELIMINARY ACT

(Collision between 2 or more ships)

Preliminary act of plaintiff/defendant1

 1. Date of collision:

 2. Time of collision:

 3. Place of collision:

 4. Names of ships that came into collision:

 5. In relationship to ship of the party filing this preliminary act:
 (a) name of ship:
 (b) port of registry:
 (c) the name of master at time of collision:
      (d) name and address of person in command at the time of the collision and in the period immediately before the collision:
      (e) name and address of persons on