Form 83 — Report of Trustee under Subsections 171(1) and (2)

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(Subsection 171(1) and (2) of the Act)

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I, Space to insert name of trustee of estate of Space to insert city, the trustee of the estate of Space to insert name of bankrupt, bankrupt, hereby report to the Superintendent at the division office as follows:

  1. That on the Space to insert day of month day of Space to insert month Space to insert year, the bankrupt did file an assignment (or a bankruptcy order was issued against the bankrupt or the bankrupt did file a proposal which subsequently was deemed to be an assignment) (and that the undersigned was substituted trustee of the estate in the stead of Space to insert substituted trustee, as the case may be).
  2. That on or before the day of the filing of the assignment (or the making of the bankruptcy order or the filing of the proposal) the bankrupt carried on business under the name of Space to insert bankrupt's business at Space to insert name of city in the Space to insert territory of Space to insert name of territory in the County of Space to insert name of contry in the Province of Space to insert name of pronvince.
  3. That the bankrupt resides (or has its principal place of business, in the case of a corporation) in the Space to insert type of territory of Space to insert name of territory in the County of Space to insert name of country in the Province of Space to insert name of province. (and, in the case of a corporation, that the directors and officers of the bankrupt are as follows:)
    Directors:
    Name Position Address
    Space to insert name of director of the bankrupt, line 1
    Space to insert name of director of the bankrupt, line 2
    Space to insert name of director of the bankrupt, line 3    		 Space to insert name of position of director of the bankrupt, line 1
    Space to insert name of position of director of the bankrupt, line 2
    Space to insert name of position of director of the bankrupt, line 3    		 Space to insert address of director of the bankrupt, line 1
    Space to insert address of director of the bankrupt, line 2
    Space to insert address of director of the bankrupt, line 3
    Officers:
    Name Position Address
    Space to insert name of officer of the bankrupt, line 1
    Space to insert name of officer of the bankrupt, line 2
    Space to insert name of officer of the bankrupt, line 3    		 Space to insert name of position of officer of the bankrupt, line 1
    Space to insert name of position of officer of the bankrupt, line 2
    Space to insert name of position of officer of the bankrupt, line 3    		 Space to insert address of officer of the bankrupt, line 1
    Space to insert address of officer of the bankrupt, line 2
    Space to insert address of officer of the bankrupt, line 3
  4. That I am of the opinion that:

    (a) The persons who actively controlled the day-to-day operations or the business of the bankrupt are as follows:

    persons who actively controlled the day-to-day operations or the business of the bankrupt:
    Name Position Address
    Space to insert name of persons who actively controlled the day-to-day operations, line 1
    Space to insert name of persons who actively controlled the day-to-day operations, line 2
    Space to insert name of persons who actively controlled the day-to-day operations, line 3    		 Space to insert positions of persons who actively controlled the day-to-day operations, line 1
    Space to insert positions of persons who actively controlled the day-to-day operations, line 2
    Space to insert positions of persons who actively controlled the day-to-day operations, line 3    		 Space to insert address of persons who actively controlled the day-to-day operations, line 1
    Space to insert address of persons who actively controlled the day-to-day operations, line 2
    Space to insert address of persons who actively controlled the day-to-day operations, line 3

    (b) The persons who were responsible for, or under whose directions were incurred, the greater proportion of the bankrupt's liabilities are as follows:

    Persons who were responsible for, or under whose directions were incurred, the greater proportion of the bankrupt's liabilities:
    Name Position Address
    Space to insert name of persons who were responsible for the bankrupt's liabilities, line 1
    Space to insert name of persons who were responsible for the bankrupt's liabilities, line 2
    Space to insert name of persons who were responsible for the bankrupt's liabilities, line 3    		 Space to insert positions of persons who were responsible for the bankrupt's liabilities, line 1
    Space to insert positions of persons who were responsible for the bankrupt's liabilities, line 2
    Space to insert positions of persons who were responsible for the bankrupt's liabilities, line 3    		 Space to insert addresses of persons who were responsible for the bankrupt's liabilities, line 1
    Space to insert addresses of persons who were responsible for the bankrupt's liabilities, line 2
    Space to insert addresses of persons who were responsible for the bankrupt's liabilities, line 3
  5. That, having made a careful inquiry into the affairs of the bankrupt, I am further of the opinion that the deficiency between the assets and the liabilities of the debtor has (or has not) been satisfactorily accounted for (and, as the case may be, there is evidence of a substantial disappearance of property that is not accounted for.

    Dated at Space to insert name of 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

    (At this point the report is ended for purposes of subsection 171(2) and a copy is to be forwarded by registered or certified mail in an envelope marked "private and confidential" to each of the persons named in paragraphs 3 and 4, immediately after the report is filed with the Superintendent of Bankruptcy pursuant to subsection 171(1). The report filed with the Superintendent, however, will include the following paragraphs which must ONLY be made available to the Superintendent.)
  6. That, having made a careful inquiry into the conduct of the bankrupt and other persons hereinbefore named (and having consulted with the inspectors and other persons, as the case may be), I am further of the opinion that the probable causes of the bankruptcy are as follows:

    (Specify the probable cause or causes as set out in paragraph 171(1)(c).)

    (I) misfortune.

    (ii) inexperience.

    (iii) incompetence.

    (iv) carelessness.

    (v) over-expansion.

    (vi) unwarranted speculation.

    (vii) gross negligence.

    (viii) fraud, and

    (ix) other probable cause.

  7. That I have arrived at my opinions herein before expressed for the following reasons:

    (a)(I) (State or name the source of information and verification thereof regarding persons named in 4.(a).)

    (ii) (State or name the source of information and verification thereof regarding persons named in 4.(a).)

    (b) (Set out by what facts or information and verification or investigation thereof the trustee has arrived at his/her opinions expressed in paragraph 5., treating the matters as fully as the trustee has been able to ascertain them, attaching a copy of the bankrupt's last audited financial statement or the bankrupt's financial statement for the last fiscal period, whichever is the latest and any other statements, affidavits and opinions that are necessary and naming or stating sources of information and verification thereof.)

Dated at Space to insert name of 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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