Form 44 — Certificate of Assignment

(Subsection 63(6) of the Act)

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District of Space to insert District

Division No. Space to insert Division number

Court No. Space to insert court number

Estate No. Space to insert estate number

In the matter of the bankruptcy of:

Space to insert debtor's name
Debtor

Space to insert trustee's name
Trustee

Space to insert administration
Administration

Date of Bankruptcy: Space to insert date of bankruptcy

Security: Space to insert security

Date of Initial Bankruptcy Event: Space to insert date of initial bankruptcy event

Meeting of Creditors: Space to insert meeting of creditors

Chairman: Space to insert chairman's name

Designated Person: Space to insert designated person

Certificate of Assignment - Section 63

I, the undersigned, Official Receiver in and for this bankruptcy district, do hereby certify that:

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a proposal in respect of the aforenamed debtor was filed under section 62 of the Bankruptcy and Insolvency Act;

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the said proposal, although accepted and approved, has been annulled by order of the court and the debtor is thereupon deemed to have made an assignment.

The aforenamed trustee is required:

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to provide to me, without delay, security in the aforementioned amount;

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to send to all creditors, within five days after the date of the trustee's appointment, a notice of the bankruptcy; and

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when applicable to call in the prescribed manner, a first meeting of creditors, to be held at the aforementioned time and place or at any other time and place that may be later requested by the Official Receiver.

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Date

Space to insert official receiver's signature
Official Receiver

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