Form 2—Application for Trustee Licence (Individual) (br02156)

PDF version

Form 2

75 KB, 7 pages

(Subsection 13(1) of the Act)


General Information

Candidate’s Name (as you would like it to appear on a trustee licence)

Family Name

Space to insert Family Name

Given Name(s)

Space to insert Given Name(s)

Date of Birth

Space to insert year of birth /Space to insert month of birth /Space to insert day of birth
 YearMonthDay

Other Previous Legal Names or Aliases

Space to insert Other Previous Legal Names or Aliases

Business Address

Space to insert business address, line 1

Space to insert business address, line 2

Space to insert business address, line 3

Telephone No. Space to insert telephone number

Fax No. Space to insert Fax number

Email Address

Space to insert email address

Home Address

Space to insert Home address, line 1

Space to insert Home address, line 2

Space to insert Home address, line 3

Telephone No. Space to insert telephone number

Fax No. Space to insert fax number

Current Employer

Space to insert name of current employer

Employment Began

Space to insert year of when employment began /Space to insert month of when employment began /Space to insert day of when employment began
YearMonthDay

Professional organization(s) of which you are or were a member (if any)

Space to insert name of Professional organization(s), line 1

Space to insert name of Professional organization(s), line 2

Space to insert name of Professional organization(s), line 3

Bankruptcy district(s) for which a licence is requested: Space to insert Bankruptcy District(s)

Attestation Regarding Prerequisite Qualifications

I hereby attest, pursuant to to the Directive on Trustee Licensing, that:

  1. I am not an insolvent person nor have I been in a state of insolvencyFootnote 1 at any time within the five (5) years preceding the date of this application.;
  2. I have:
    1. successfully completed the Chartered Insolvency and Restructuring Professional (CIRP) Qualification Program (CQP), unless otherwise exempted;
    2. passed the CIRP National Insolvency Examination (CNIE); and
    3. successfully completed the Insolvency Counsellor's Qualification Course (ICQC), or I have enrolled in the ICQC and I agree to successfully complete the course before obtaining a licence.
  3. I am in good standing with, and I am not subject to any current disciplinary action by, any professional organization of which I am or was a member.

Declaration Regarding Reputation

To assess whether you satisfy the reputation requirements under the Directive on Trustee Licensing, please answer the following questions:

  1. Have you ever been found guilty of an indictable offence for which a pardon has not been granted?

    Yes Select if you have ever been found guilty of an indictable offence for which a pardon has not been granted No Select if you have never been found guilty of an indictable offence for which a pardon has not been granted

    If yes, please provide details on the nature of the offence(s):
    Field 1 to insert details on the nature of the offence(s), first line
    Field 2 to insert details on the nature of the offence(s), second line
    Field 3 to insert details on the nature of the offence(s), third line

  2. Have you ever been found guilty of professional misconduct by any professional organization of which you are or were a member?

    Yes Select if you have ever been found guilty of professional misconduct by any professional organization of which you are or were a memberNo Select if you have never been found guilty of professional misconduct by any professional organization of which you are or were a member

    If yes, please provide details on the nature of the misconduct:
    Field 1 to insert details on the nature of the misconduct, first line
    Field 2 to insert details on the nature of the misconduct, second line
    Field 3 to insert details on the nature of the misconduct, third line

  3. Have you ever been in a state of insolvency?

    Yes Select if you have ever been in a state of insolvencyNo Select if you have never been in a state of insolvency

    If yes, please provide details (estate name, estate number, district of the filing, date of discharge, etc.).
    Field 1 to insert details of the insolvency, first line
    Field 2 to insert details of the insolvency, second line
    Field 3 to insert details of the insolvency, third line

  4. Have you ever been a principal shareholder, director or officer of a bankrupt corporation?

    Yes Select if you have ever been a principal shareholder, director or officer of a bankrupt corporation No Select if you have never been a principal shareholder, director or officer of a bankrupt corporation

    If yes, please provide details (corporation's estate name, estate number, district of the filing, date of discharge, etc.):
    Field 1 to insert details on the corporation in which you were a principal shareholder, first line
    Field 2 to insert details on the corporation in which you were a principal shareholder, second line
    Field 3 to insert details on the corporation in which you were a principal shareholder, third line

Incompatible Activity

I attest that, should I be granted a trustee licence, I will not engage in an incompatible activity, including any activity that would or may be perceived to create a conflict of duties, compromise my ability to perform any professional engagement, or jeopardize my integrity, independence or competence, including, but not limited to, the activities of a collection agent, a bailiff, an employee of the Office of the Superintendent of Bankruptcy (except when acting pursuant to sections 14.03 or 29 of the Act), a lawyer or a notary in the Province of Quebec.

Consent and Authorization

I hereby consent to and authorize:

  1. the Canadian Association of Insolvency and Restructuring Professionals (CAIRP) to share with the Office of the Superintendent of Bankruptcy (OSB):
    1. the information that appears on my application to challenge the CNIE for the year that I passed the CNIE;
    2. any information appearing on any experience report I may have submitted prior to challenging the CNIE; and
    3. the results I obtained at the CNIE, both globally and on a per competency basis;
  2. the OSB to share with CAIRP details of both this application and the results of my Oral Board of Examination;
  3. the OSB to publish my name and contact information on the Trustee Registry that is posted on the OSB website if I am granted a trustee licence; and
  4. the OSB to record my oral examination in accordance with the Policy on Recording the Office of the Superintendent of Bankruptcy’s Oral Examination.

Disclosure Authorization for Release of Information

I understand that my application for a trustee licence is subject to an investigation and verification by the Royal Canadian Mounted Police (RCMP) regarding criminal records, ongoing or completed investigations and arrest warrants, as well as regarding 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.

(Please initial) Space to insert initials

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. I further confirm that an original copy of Form 2, including required documentation along with a cheque for $300 payable to the Receiver General of Canada, will be mailed to the OSB, within 24 hours of emailing this application, at the following address:

Innovation, Science and Economic Development Canada
Office of the Superintendent of Bankruptcy
Licensing Services
Heritage Place
155 Queen Street, 4th Floor
Ottawa, Ontario K1A 0H5

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 Applicant's name
Applicant's name in block letters

Space to insert Signature of applicant
Signature of applicant

Required Documentation

Please include the documents listed below with your application. If any items are not provided, please indicate the reason for the information being excluded and the date when it will be provided to the Office of the Superintendent of Bankruptcy.

  1. A criminal record check from a Canadian Law Enforcement Agency.
  2. A copy of your certificate of completion of the Insolvency Counsellor’s Qualification Course or proof of enrolment.
  3. A curriculum vitæ containing your academic background and a list of employment positions held during the last ten (10) years.
  4. A detailed description of your experience in insolvency matters (see attached table).
  5. A letter from your sponsor attesting to the fact that you are ready to appear before an Oral Board of Examination and that any areas for improvement identified via the sponsor or the CNIE results have been adequately addressed.
Where you intend to practise either with a trustee firm (i.e., partnership or corporate licence) or as an employee of another trustee:
  1. A supporting letter in which a partner or the employer undertakes to provide the necessary resources (work facilities, equipment and personnel) that will be required for the execution of your duties as a trustee, as well as insurance coverage (professional liability insurance and employee dishonesty (fidelity) insurance).
In all other cases (to obtain authorization to begin accepting professional engagements):
  1. A personal balance sheet.
  2. Details of necessary resources (work facilities, equipment and personnel) that will be at your disposal during the execution of your duties as a trustee, and of banking arrangements.
  3. Proof of insurance coverage (professional liability insurance and employee dishonesty (fidelity) insurance).
Application for a Trustee Licence — Breakdown of Areas of Experience in Insolvency Matters
Application for a Trustee Licence — Breakdown of Areas of Experience in Insolvency Matters

Name of Applicant: Space to insert name of applicant for a Trustee Licence  Firm: Space to insert name of firm

Please provide a list of the main activities you performed in relation to each category of work listed below together with your best estimate as to the percentage (%) of time expended on the activities throughout the experience period.

Consumer BankruptciesConsumer Proposals
Percentage of overall time during the year Space to insert percentage of overall time during year for consumer bankruptciesPercentage of overall time during the year Space to insert percentage of overall time during year for consumer proposals
Commercial BankruptciesCommercial Proposals / CCAA
Percentage of overall time during the year Space to insert percentage of overall time during year for commercial bankruptciesPercentage of overall time during the year Space to insert percentage of overall time during year for commercial proposals / CCAA
Interim ReceivershipsReceiverships, Agent or Mandatory,
Look-see, Secured Creditors
Percentage of overall time during the year Space to insert percentage of overall time during year for interim receivershipsPercentage of overall time during the year Space to insert percentage of overall time during year for Receiverships, Agent or Mandatory,Look-see, Secured Creditors
Other non-insolvency work (i.e., audit, tax, accounting, forensic accounting)
Percentage of overall time during the year Space to insert percentage of overall time during year for other work not directly related to insolvency work (audit, tax, accounting, forensic)
Total years of experience:Space to insert total years of experience working in insolvency matters

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

Space to insert Signature of applicant in application for trustee license
Signature of applicant

Date:Space to insert date in application for trustee license

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

Space to insert Signature of trustee in application for trustee license
Signature of Licensed Insolvency Trustee

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

Date:Space to insert date of trustee signature in application for trustee license

Important Notices

This form is to be completed in OLAA.

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.