Form 77—Notice of Disallowance of Claim, Right to Priority or Security or Notice of Valuation of Claim

PDF version

Form 77

KB, 1 page

(Subsection 135(3) of the Act)

Take notice that:

(A) as trustee acting in the matter of the bankruptcy (or proposal) of Space to insert bankrupt's name , I have disallowed your claim (or your right to a priority or your security on the property) in whole (or to the extent of $Space to insert amount of disallowance ), pursuant to subsection 135(2) of the Act, for the following reasons:

(Set out the reasons for the disallowance.)


(B) as trustee acting in the matter of the bankruptcy (or proposal) of Space to insert name of bankrupt , I have determined that your contingent or unliquidated claim is a provable claim and have valued it at $Space to insert amount of claim and therefore, it is deemed a proved claim to this amount pursuant to subsection 135(1.1) of the Act.

And further take notice that if you are dissatisfied with my decision in disallowing your claim in whole or in part (or a right to rank or your security or valuation of your claim), you may appeal to the court within the 30-day period after the day on which this notice is served, or within any other period that the court may, on application made within the same 30-day period, allow.

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
Licensed Insolvency Trustee

Important Notices

This form may not be completed online. It is provided here for reference purposes only.

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.

Date modified: