Form 63—Mediation Settlement Agreement

PDF version

Form 63

41 KB, 2 pages

(Rule 105(18))

(For the Expedited Mediation Process, insert:)

Mediation Settlement Agreement – Expedited Mediation Process

(Rule 105(18))


(Title Form 1)

Checkbox: Final Final Checkbox: Draft Draft

The parties acknowledge that an agreement was reached in the mediation held on Space to insert day, the Space to insert day day of Space to insert month  Space to insert year, and that the results of the mediation are as follows:

First space to insert results of the mediation
Second space to insert results of the mediation
Third space to insert results of the mediation
Fourth space to insert results of the mediation
Fifth space to insert results of the mediation

(For the Expedited Mediation Process, use the following box:)

The parties acknowledge that an agreement was reached before the mediation session and was confirmed by email on Space to insert day, the Space to insert day day of Space to insert month  Space to insert year, and that the results of the mediation are as follows:

First space to insert results of the mediation
Second space to insert results of the mediation
Third space to insert results of the mediation
Fourth space to insert results of the mediation
Fifth space to insert results of the mediation

Confidentiality

We accept that the mediator cannot be asked by any of the parties to testify in any proceedings before a court of law.

We accept that all statements or documents obtained during the course of mediation, which would not have been obtained otherwise, will not be used when discussing the matter before the court or during any other proceedings. Also, we accept that all the information obtained during the course of mediation will not be admissible as evidence or to impeach the credibility of a party.

We understand that the mediator or any party to the mediation shall not disclose to the public any confidential information concerning an issue submitted to mediation unless the disclosure is:

  1. Required by law, in such cases where one party has committed an offence in violation of the Bankruptcy and Insolvency Act or any other legislation.
  2. Authorized by the person to whom the confidential information relates.

Signature of the mediation agreement

We hereby agree that this agreement may be signed in counterparts and submitted electronically to the Office of the Superintendent of Bankruptcy.

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

Space to insert signature of bankrupt
Bankrupt
Space to insert signature of bankrupt's legal counsel
Bankrupt’s Legal Counsel
(if applicable)
Space to insert signature of trustee
Licensed Insolvency Trustee
Space to insert signature of trustee's legal counsel
Licensed Insolvency Trustee’s Legal Counsel
(if applicable)
Space to insert signature of creditor
Creditor
(as applicable)
Space to insert signature of creditor's legal counsel
Creditor’s Legal Counsel
(if applicable)