Form 60 — Request for Mediation Made by Trustee

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(Subsections 68(6), 68(7) and 170.1(5))

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(Title Form 1)

I, Space to insert trustee of the estate , trustee of the estate of Space to insert the bankrupt , bankrupt, who made an assignment (or against whom a bankruptcy order was made) on the Space to insert day of month day of Space to insert month Space to insert year, hereby apply to the official receiver to refer this matter to the mediator, who shall set the time and place for the mediation.

This application for mediation is being made for the following reasons:

(Check appropriate description)

Subsection 68(6) - There is disagreement as to the amount of surplus income to be paid by the bankrupt.

Subsection 68(7) - There is a written request from Space to insert creditor's name , a creditor, Space to insert creditor's address (creditor's address), to proceed with the mediation process.

Subsection 170.1(4) - The bankrupt does not agree with the discharge recommendation of the trustee.

Subsection 170.1(5) - The trustee is opposed to the discharge of the bankrupt on a ground referred to in paragraph 173(1)(m) or (n) of the Act.

Subsection 170.1(5) - Space to insert creditor's name , a creditor, Space to insert creditor's address (creditor's address), is opposed to the discharge of the bankrupt on a ground referred to in paragraph 173(1)(m) or (n) of the Act.

An income and expense statement of the bankrupt is attached to this request (Form 65).

(Indicate name, address, phone numbers of all parties)

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

Space to insert trustee's signature
Trustee

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