Form 2—Application for Trustee Licence (Individual)

For persons to which the 2009 amendments do not apply

(Subsection 13(1) of the Act)


General Information

Family Name

Space to insert family name

Given Name(s)

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Date of birth

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YearMonthDay

Other Previous Legal Names or Aliases

Space to insert other previous legal names or aliases

Business Address

Space to insert 1st line of business address

Space to insert 2nd line of business address

Space to insert 3rd line of business address

Telephone No.

Space to insert business telephone number

Fax No.

Space to insert business fax number

E-mail address

Space to insert business E-mail

Home Address

Space to insert 1st line of home address

Space to insert 2nd line of home address

Space to insert 3rd line of home address

Telephone No.

Space to insert home telephone No.

Fax No.

Space to insert home fax No.

Current Employer

Space to insert current employer name

Employment Began

Space to employment year / Space to employment month / Space to insert employment birth
YearMonthDay

Professional organization(s) of which I am currently a member (if any)

Space to insert 1st professional organization(s) name

Space to insert 2nd professional organization(s) name

Space to insert 3rd professional organization(s) name

Bankruptcy District(s) for which Licence is requested

Space to insert 1st Bankruptcy District name

Space to insert 2nd Bankruptcy District name

Space to insert 3rd Bankruptcy District name

Prerequisite Qualifications

Formal education (degrees, professional designations, year of conferment, post-secondary institutions) and relevant work experience. Please provide a curriculum vitae

Declaration Regarding Prerequisite Qualifications

I hereby declare that:

  1. I have not, at any time within the 5 years preceding the date of this application, personally been in a state of insolvencyFootnote 1;
  2. I have successfully completed the BIA Insolvency Counsellor's Qualification Course;
  3. I have successfully completed the National Insolvency Qualification Program;
  4. As a member or former member of a professional organization, I am in good standing with, and am not subject to any current disciplinary action by that organization.

Specific Qualifications

If you are a member of a professional organization, do you intend to retain your membership in that organization when you begin to practice as a trustee?

Yes Select box if yes. No Select box if no.

(If yes, and if such membership entitles you to practice a profession that is an incompatible occupationFootnote 2, you are required to satisfy the Superintendent that you will be a non-practising member of the organization. Please refer to sections 33 to 36 of the Directive.)

Declaration Relating to the Applicants's Reputation

I hereby declare that:

  1. I have no criminal record;
  2. I have never been a bankrupt;
  3. I have never been a principal shareholder, a director or an officer of a bankrupt corporation;
  4. As a member or former member of a professional organization, I have not previously been found guilty of professional misconduct of an ethical, commercial or economic nature; except as indicated hereafter (please provide documentation):

Undertaking of Applicant Regarding Conditions Imposed on New Licences

If a trustee licence is granted by the Superintendent of Bankruptcy, I accept that it be subject to the following conditions:

  1. that I will, for a period of twenty-four (24) months, practice with, and in the same physical location as, an active established trustee who is acceptable to the Superintendent.
  2. that if, at any time during those twenty-four (24) months, I do not meet the requirement set forth in paragraph (a), I will be authorized to act only in the following cases:
    1. consumer proposals;
    2. estates under the summary administration provisions of the Act;
    3. estates, known as ordinary administration estates, for which the unsecured liabilities, as per the Statement of Affairs, do not exceed $500,000 and for which the realizable assets as per the Statement of Affairs, after deducting the value of all security interests, do not exceed $15,000; and
    4. all other cases (notice of intention, Division I proposal, Interim Receiver, estates not covered by case (iii) above, etc.) , subject to the approval of the Division Assistant Superintendent (DAS) and on any terms that the DAS shall determine, considering my performance.

These conditions will not necessarily restrict me to any specific employer and any transfer or change of employment assuring similar or better circumstances would be acceptable. I will inform you in advance of any such change.

I also accept that these conditions may, upon written request, be reviewed after the period of twenty-four (24) months. They will thus either be removed, modified or maintained.

If other conditions are to apply, I will be so notified by the Superintendent, prior to the granting of the licence, for my approval.

Authorization

I understand that my application for a trustee licence is subject to an investigation, and that a verification by the Royal Canadian Mounted Police (RCMP) will be conducted with regard to criminal records, ongoing or completed investigations and arrest warrants, as well as with regard to my background. I hereby authorize and give consent to the RCMP or other police forces to release personal information and make full disclosure to the Office of the Superintendent of Bankruptcy, as provided by the Privacy Act.

Declaration and Signature

I, the undersigned, do solemnly declare that I am the applicant named in this application and that the information set out in this application and in the attached documents is, to the best of my knowledge and belief, true, correct and complete in all respects, and that I agree to respect the conditions contained in this form, if the Superintendent issues me a licence.

Dated at Space to insert city, this Space to insert day of application day of Space to insert month and year of application

Space to insert applicant's name
Applicant's name in block letters

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Signature of applicant


Application for a Trustee Licence

Breakdown of Area of Experience in Insolvency Matters

Name of Applicant:

Space to insert trustee licence's applicant name

Firm:

Space to insert trustee licence's applicant firm

The applicant for a trustee licence hereunder indicates an estimate of the amount of time worked during the periods indicated, in the various fields indicated. The breakdown is to be shown as a percentage (%) of the overall time during the year.

Application for a Trustee Licence – Breakdown of Area of Experience in Insolvency Matters
  Consumer Bankr. Consumer Proposals Comm. Bankr. Comm. Proposals Interim Rec. Rec., Agency, Look-see, Secured Creditors, CCAA Other work not directly related to insolvency work (audit, tax, accounting, forensic)
Previous Year              
During Space to insert 1st previous year (year)              
During Space to insert 2nd previous year (year)              
During Space to insert 3rd previous year (year)              

I, the undersigned applicant for a trustee licence, hereby attest that the above information faithfully reflects my experience in insolvency and other fields during the periods shown above.

Space to insert trustee licence's signature of applicant
Signature of Applicant

Date: Space to insert applicant signature's year / Space to insert applicant signature's month / Space to insert applicant signature's day
YearMonthDay

I, the undersigned, a trustee of the firm where the above applicant trustee is presently employed or associated, hereby attest that the information provided by the applicant trustee, for the period of time with this firm, faithfully reflects the extent of his/her experience in the insolvency and other fields.

Space to insert signature of trustee
Signature of Trustee

Space to insert trustee's name in block letters
Trustee's name in block letters

Date: Space to insert applicant signature's year / Space to insert trustee signature's month / Space to insert trustee signature's day
YearMonthDay

The Following must also be Provided with this Application

Please fill out this page and return with your application. If any items are not checked off, please indicate the reason for this information being excluded and the date at which it will be provided.

Select box if a copy of the applicant's certificate of completion of the Insolvency Counsellor's Qualification Course is included. 1. A copy of the applicant's certificate of completion of the Insolvency Counsellor's Qualification Course.

Select box if a curriculum vitae containing the applicant's academic background and a list of employment positions held during the last ten years with a brief description of duties is included. 2. A curriculum vitae containing the applicant's academic background and a list of employment positions held during the last ten (10) years with a brief description of duties.

Select box if a detailed description of experience in bankruptcy administration is included. 3. A detailed description of experience in bankruptcy administration.

Select box if a recent photograph of the applicant is included. 4. A recent photograph of the applicant (approx. 5 cm X 3.5 cm).

Select box if a cheque for $300 payable to the Receiver General of Canada is included. 5. A cheque for $300 payable to the Receiver General of Canada.

If the applicant intends to practice either with a trustee firm (i.e. partnership or corporate licence), or as an employee of another trustee:

Select box if a supporting letter in which the employer or a partner undertakes to provide the necessary resources that will be required by the applicant for the execution of his/her duties as a trustee, as well as insurance coverage is included. 6. A supporting letter in which the employer or a partner undertakes to provide the necessary resources (work facilities, equipment and personnel) that will be required by the applicant for the execution of his/her duties as a trustee, as well as insurance coverage (professional liability insurance and employee dishonesty (fidelity) insurance).

In all other cases (in order to obtain authorization to begin accepting professional engagements):

Select box if a personal balance sheet is included. 7. A personal balance sheet.

Select box if a personal balance sheet is included. 8. Details of necessary resources (work facilities, equipment and personnel) that will be at the applicant's disposal in the execution of his/her duties as a trustee, and of banking arrangements.

elect box if evidence of insurance coverage for the applicant (professional liability insurance and employee dishonesty (fidelity) insurance) is included. 9. Evidence of insurance coverage for the applicant (professional liability insurance and employee dishonesty (fidelity) insurance).

Important Notices

This form may not be completed online. It is provided here for reference purposes only.

The HTML version of this Form is not the official version. In the event of an inconsistency between the HTML and PDF versions of this Form, the PDF version prevails. Users are required to exercise due diligence with respect to the HTML version.

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