C.R.S. § 13-62.3-104

This completed form, together with the documents required by Subpart V, should be filed with the Clerk of the District Court. When stating a sum of money, identify the currency in which the sum is stated. I. Identification of Canadian Judgment Canadian Court Rendering the Judgment: _____________________ Case/Docket Number in Canadian Court: _____________________ Name of Plaintiff: ___________________________ Name of Defendant: _________________________ The Canadian Court entered the judgment on _______ [Date] in _________ [City] in ___________________ [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 sections 13-62.3-103 (2) and (3), Colorado Revised Statutes), describe the part of the judgment being registered. _______________________. II. Identification of Person Registering Judgment and Person Against Whom Judgment is Being Registered Name of Person Registering Judgment: _______________________. If the person registering the judgment is not the person in whose favor the judgment was rendered, describe the interest in the judgment of the person registering the judgment that entitles the person to seek its recognition and enforcement. ___________ Address: _______________________________________________ Additional Contact Information for Person Registering Judgment (optional): Telephone Number: __________ FAX Number: ________________ E-mail Address: _______________________ Name of Attorney for Person Registering Judgment, if any: _____________________ Address: _______________________________________________ Telephone Number: __________ FAX Number: _________________ E-mail Address: _______________________ Name of Person Against Whom Judgment is Being Registered: _________________ Address: ____________________________________ (provide the most recent address known) Additional Contact Information for Person Against Whom Judgment is Being Registered (optional) (provide most recent information known): Telephone Number: ____________ FAX Number: _______________ E-mail Address: _____________________________ III. Calculation of Amount for Which Enforcement is Sought 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 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 that represents an award of attorney's fees). The Canadian Court awarded attorney's 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 of _____________ and post-judgment attorney's fees 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 that 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 ______________________. IV. Statement of Person Registering Judgment I, __________________ [Person Registering Judgment or Attorney for Person Registering Judgment], state: 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 Canadian judgment being registered is within the scope of article 62.3 of title 13, Colorado Revised Statutes. 3. If only a part of the Canadian judgment is being registered, the amounts stated in Subpart III of the registration relate to that 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 as accurate by the Canadian Court that entered the judgment in accordance with section 13-53-103, Colorado Revised Statutes. _____ If the Canadian judgment is not in English, a certified translation of the judgment into English. _____ A docket fee in the amount of $201.00. I declare that the information provided on this form is true and correct, except as to matters stated to be on information and belief and, as to those matters, I believe them to be true. Submitted by: ______________________ Person Registering Judgment or Attorney for Person Registering Judgment (specify whether signer is the person registering the judgment or that person's attorney) Date of submission: _________________