Form 6.14	Certificate of order and depositions—div 6.10.9 examination
Court Procedures Rules 2006
(see r 6849 (Certificate of order and depositions—div 6.10.9 examination))

I certify that the following items are annexed:
1.	The order of the Supreme Court of the Australian Capital Territory under rule 6843 (Order relating to taking evidence for Australian or foreign court or tribunal) (the division 6.10.9 order), dated (date), made on application made under a request issued *[by/on behalf of] (name of requesting court) in relation to a proceeding that *[has been/may be] brought before (name of requesting court) between (name of plaintiff) and (name of defendant) dated (date);
2.	The original record of the deposition *[and transcripts of that record] of the evidence given at the examination under the division 6.10.9 order on (date).
*[3.	The exhibits produced during the examination under the division 6.10.9 order, as follows:
	(include description of exhibits).]
Date:
(signature of Registrar and seal of Court)

*omit if, or whichever is, inapplicable