APPLICATION TO REQUEST A DIN TORAH Date: Year —Please choose an option—2024202320222021 Month —Please choose an option—JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember Day —Please choose an option—12345678910111213141516171819202122232425262728293031 Plaintiff Name: Company Name: Address: City: State/Province: Postal Code: Home Tel: Business Tel: Cell: Fax: E-mail: Credit Card: Expiry Date: CCV: Defendant Name: Company Name: Address: City: State/Province: Postal Code: Home Tel: Business Tel: Cell: Fax: E-mail: Add+ Defendant Name: Company Name: Address: City: State/Province: Postal Code: Home Tel: Business Tel: Cell: Fax: E-mail: Add+ Defendant Name: Company Name: Address: City: State/Province: Postal Code: Home Tel: Business Tel: Cell: Fax: E-mail: Add+ Defendant Name: Company Name: Address: City: State/Province: Postal Code: Home Tel: Business Tel: Cell: Fax: E-mail: Add+ Defendant Name: Company Name: Address: City: State/Province: Postal Code: Home Tel: Business Tel: Cell: Fax: E-mail: Add+ Defendant Name: Company Name: Address: City: State/Province: Postal Code: Home Tel: Business Tel: Cell: Fax: E-mail: Please describe the nature of the claim: What is the amount of the claim? Has this claim previously been referred for mediation to any Rabbi or addressed in a Civil Court or Beth Din? If so, please provide a brief history There is a non-refundable fee of $250.00 for the Beth Din to process your claim. At the time when the hearing is scheduled further charges are applicable. Each party is required to pay $400.00 per two- hour session. Overtime will be charged at $250.00 per hour. In special circumstances (e.g.certain complex litigations), additional fees may be applied. Should you require more information kindly reach out to: ajunger@bethdin.ca TRIBUNAL RABBINIQUE RABBINICAL COURT OF GREATER MONTREAL 6819 Decarie, Montreal, Quebec H3W 3E4 Tel: (514) 739-6363 Fax: (514) 739-7024