Form 3—Debtor Company Information Summary (Following the Order Discharging the Monitor)


(To be filed with the Superintendent of Bankruptcy under paragraph 23(1)(f) of the Companies' Creditors Arrangement Act)

Part 1 — Information respecting debtor company

1. Name of debtor company:

space to insert name of debtor company

2. File number assigned by the Superintendent of Bankruptcy:

space to insert file number assigned by the Superintendent of Bankruptcy

3. Date of the most recent consolidated financial statements for debtor company:

space to insert year/space to insert month/space to insert day (yyyy/mm/dd)

4. The statements referred to in item 3 are:

Checkbox audited (Name of auditor:space to insert name of debtor company)

Checkbox unaudited

5. Book values for the debtor company set out in the statements referred to in item 3:

  • Book value of total assets: $space to insert book value of total assets
  • Book value of total liabilities: $space to insert book value of total liabilities
    • secured: $space to insert amount secured
    • unsecured: $space to insert amount unsecured
    • trust claims: $space to insert trust claims
  • Book value of total liabilities that are contingent: $space to insert book value of total liabilities that are contingent

6. Does the debtor company participate in any prescribed pension plan for the benefit of its employees? Checkbox yes Checkbox no

If yes, give name of each plan and indicate whether it is a defined benefit or defined contribution plan:

space to insert, if yes, give name of each plan and indicate whether it is a defined benefit or defined contribution plan, line 1

space to insert, if yes, give name of each plan and indicate whether it is a defined benefit or defined contribution plan, line 2

space to insert, if yes, give name of each plan and indicate whether it is a defined benefit or defined contribution plan, line 2

Part 2 — Information respecting proceedings

7. Was interim financing granted by court order under section 11.2 of the Act?
Checkbox yes Checkbox no

If yes,

  • amount of interim financing granted by court order: $space to insert amount of interim financing granted by court order
  • amount drawn: $space to insert amount drawn

8. Was a compromise or arrangement sanctioned by the court?  Checkbox yes Checkbox no

If yes,

  • Date on which the compromise or arrangement was sanctioned by the court:space to insert year/space to insert month/space to insert day (yyyy/mm/dd)
  • Was the compromise or arrangement approved by the creditors before the initial application was made? Checkbox yes Checkbox no
  • Was the compromise or arrangement completed? Checkbox yes Checkbox no

9. Name of debtor company at time of monitor's discharge:

space to insert name of debtor company at time of monitor's discharge, line 1

space to insert name of debtor company at time of monitor's discharge, line 2

Part 3 — To be completed if there is a foreign proceeding

10. Name of foreign representative: space to insert name of foreign representative

11. Country, name of court, judicial district and court file number:

space to insert country and name of court

space to insert judicial district

space to insert court file number

12. Indicate if the proceeding is a

Checkbox a foreign main proceeding, or

Checkbox a foreign non-main proceeding.

13. Date of first order in foreign proceeding: space to insert year/space to insert month/space to insert day (yyyy/mm/dd)

Dated at space to insert city, space to insert province, on space to insert day and month, 20space to insert year.

space to insert signature of monitor's representative responsible for the proceedings
Monitor's representative
responsible for the proceedings