Form 36 — Proxy

PDF version
(19 KB, 1 page)

PDF readers

(Subsection 102(2) and paragraphs 51(1)(e) and 66.15(3)(b) of the Act)

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

(Title Form 1)

I, Form Field (name of creditor), of Form Field (name of town or city), a creditor in the above matter, hereby appoint Form Field , of Form Field , to be my proxy holder in the above matter, except as to the receipt of dividends, with (or without) power to appoint another proxy holder in his or her place.

Dated at Form Field , this Form Field day of Form Field Form Field .

Form Field
Witness

Form Field
Individual Creditor

Form Field
Name of Corporate Creditor

Form Field
Witness

Per Form Field
Name and Title of Signing Officer

Note: If a copy of this Form is sent electronically by means such as email, the name and contact information of the sender, prescribed in Form 1.1, must be added at the end of the document.

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