Notice of Bankruptcy and First Meeting of Creditors / 7828659

FRANÇAIS AU DOS
Province of QUEBEC
District of Quebec
Division No: 01 - Saint-Hyacinthe
Court No: 750-11-004102-163
Estate No : 41-2115648
SUPERIOR COURT
“In Bankruptcy and Insolvency”
IN THE MATTER OF THE BANKRUPTCY OF:
7828659 CANADA INC., doing business under the names of
Groupe Métaux Picard, Métaux Picard & Fille and Picard Scrap
Metal Group, a body duly incorporated according to law, having
its principal place of business at 750 Grand rang Saint-François,
in the City of Saint-Pie, Province of Quebec, J0H 1W0.
DEBTOR
- and PRICEWATERHOUSECOOPERS INC.
TRUSTEE
NOTICE OF BANKRUPTCY AND FIRST MEETING OF CREDITORS
(Subsection 102(1) of the Act)
Take notice that:
1.
7828659 Canada Inc. filed an assignment on the 27th day of April 2016, and the undersigned,
PricewaterhouseCoopers Inc., Licensed Insolvency Trustee (Philippe Jordan, CPA, CMA, CIRP, LIT,
trustee in charge), was appointed as trustee of the estate of the bankrupt by the official receiver,
subject to affirmation by the creditors of the trustee's appointment or substitution of another trustee
by the creditors.
2. The first meeting of creditors of the bankrupt will be held on the 24th day of May 2016, at 10:00 a.m. at
the office of the official receiver, Sun Life Building, 1155 Metcalfe Street, Room 1071, Montréal, Quebec
H3B 2V6.
3. To be entitled to vote at the meeting, a creditor must lodge with the trustee, before the meeting, a
proof of claim and, where necessary, a proxy.
4. Enclosed with this notice is a proof of claim form, proxy form and list of creditors with claims
amounting to $25 or more showing the amounts of their claims.
5. Creditors must prove their claims against the estate of the bankrupt in order to share in any
distribution of the proceeds realized from the estate.
DATED AT MONTREAL, this 4th day of May 2016.
PricewaterhouseCoopers Inc.
LICENSED INSOLVENCY TRUSTEE
Philippe Jordan, CPA, CMA, CIRP, LIT
Trustee in charge of the estate
PricewaterhouseCoopers Inc.
1250 René-Lévesque Boulevard West, Suite 2500, Montréal, Quebec, Canada H3B 4Y1
T: +1 514 205 5000, F: +1 514 876 1502, www.pwc.com/ca
District de :
Nº de division :
Nº de cour :
Nº de dossier:
Québec
01 - St-Hyacinthe
750-11-004102-163
41-2115648
Dans l'affaire de la faillite de :
7828659 Canada Inc.
Débiteur
PRICEWATERHOUSECOOPERS INC.
Syndic autorisé en insolvabilité
Administration Ordinaire
Date et heure de la faillite :
27 avril 2016, 10:01
Date de nomination du syndic :
27 avril 2016
Assemblée des créanciers :
24 mai 2016, 10:00
Sun Life Building
1155 Metcalfe Street, Salle 1071
Montréal, Québec
Canada,
Président :
Séquestre officiel
Garantie :
0.00$
CERTIFICAT DE NOMINATION - Article 49 de la Loi et Règle 85
Je soussigné, séquestre officiel pour ce district de faillite, certifie par les présentes que :
- le débiteur susmentionné a déposé une cession en vertu de l'article 49 de la Loi sur la faillite et l'insolvabilité;
- le syndic susmentionné a dûment été nommé syndic de l'actif du débiteur.
Ledit syndic doit :
me fournir sans délai une garantie au montant susmentionné;
envoyer à tous les créanciers, dans les cinq jours qui suivent la date de sa nomination, un avis de la faillite;
et
le cas échéant, convoquer de la manière prescrite une première assemblée des créanciers, qui aura lieu à la
date et à l'endroit susmentionnés, ou à telle autre date et tel autre endroit, selon ce que pourra demander
plus tard le séquestre officiel.
E-File/Dépôt Electronique
Date: 27 avril 2016, 10:36
Séquestre officiel
Sun Life Building, 1155 Metcalfe Street, Suite 950, Montréal Canada, H3B2V6, (877)376-9902
District de:
No division:
J original
-
J modifié
No cour:
No dossier:
- FORMULAIRE 78Bilan - (aiflite d'entreprise deposée par une entité
(paragraphe49(2), alinea 158d) et paragraphes5O(2) et62(1) de Ia Loi)
Dans laffaire de Ia faillite de 7828659 Canada inc.(Métaux Picard & Fine),
corporation legalement constituée, ayant sa principale place d'affaires
au 750 Grand rang Saint-Francois, dans Ta yule de Saint-Pie,
district Saint-Hyacinthe, province de Québec, JOH iWO.
AufailIi:
Vous êtes tenu de remplir avec soin et exactitude le present formulaire et les annexes applicables indiquant Ia situation de vos affaires a Ia date de votre laillite le 25
avril 2016. Une fois rempli, ce lormulaire et es isles annexées, constituent votre bilan, qui doitétre vérite sous sernient ou par une
claration solennefle.
PASSIF
(tel que declare et estirr
ACTIF
(tel que déclaré et estimé par l'officier)
par l'officier)
1. Créanciers non garantis: voir liste A .................
112,10577
Equilibre de reclamations garantis: voir liste "B ........
1,103,220.94
Créanciers non garantis total.
1,215,326.71
2. Créanciers garantis: voir lisle B .....................
3. Créanciers privilegies: voir liste C ...................
4. Dettes éventuelles, reclamations de fiducie ou autres
(voir liste D)pouvant être réclamées pour une somme de
1. Inventaire .......................................
247,818.00
2.Amenagements ...............................
000
3. Comptes a recevoir et autres créances: voir Iite E
1896,225.26
21,256.08
Bonnes ..................
0.00
Douteuses ................
1,276,481.99
Mauvaises ................
0.00
Esmation des créances qui peuvent étre réalisées
1276481.99
4.Lettres de change, billets a ordre, etc., voir liste F
0.00
0.00
5. DepOts en institutions financéres ...................
0.00
6.Especes .......................................
Total du passif ..................................
3,132,808.05
Surplus ........................................
NIL
0.00
7.Betail ..........................................
0.00
8. Machines, outillage et installation ...................
0.00
9. Immeubles et biens reels : voir tate G ...............
0.00
10.Ameublement ..................................
0.00
11.REER, FERR, Assurances-vie etc ..................
0.00
12.Valeurs mobitieres(actions, obligations, debentures etc
0.00
13. Droits en vertu de testaments .....................
0.00
14.Véhicules ...................................
8,000.00 4
15.Autres biens : voir tiste H .........................
363,925.27
Si le failli est une personne morale, a)outez.
Montant du capital souscrit
0.00
Montant du capital paye
Solde sousct et impaye
0.00
....................
0.00
Estimation du solde qui peut étre réalisé
000
Totaldel'actif ................
1,896,22526
Deficit
1,236,582.79
Je, Christian Vaillancourt, de Laval en a province de Québec, étant dUment assermenté (ou ayant déclaré solennellement) declare que le bilan qui suit et les
listes annexées sont, a ma connaissance, un relevé complel, vendique et entier de mes alfaires en ce 26 avril 2016, et indiquent au complet tous mes biens de
quelque nature qu'ils soient. en ma possession et réversibles, lets que définis par Ia Loi.
ASSERMENTE (ou declare solenneltement)
devant moi le 26 avril 2016, a Montreal en Ia province de
Julie Brunet, ommissaire a l'Assermentation
pour Ia province de Québec
Expire le 26 jan 2019
Chnstian Vaillancourl
Page 1
PricewaterhouseCoopers Inc.
Liste des créanciers / List of Creditors
dans l'affaire de la faillite de / In the matter of the Bankruptcy of
7828659 Canada Inc.
(Groupe Métaux Picard - Métaux Picard & Fille - Picard Scrap Metal Group)
Nom/Name
Adresse/Address
Créanciers garantis/Secured Creditors
Banque de Montréal
105 St-Jacques, 5e étage; Montréal QC H2Y 1L6
Total créanciers garantis/Secured Creditors
Créanciers privilégiés/Preferred Creditors
Employés
Créanciers privilégiés/Preferred Creditors
Créanciers non garantis/Unsecured
Creditors
André Pageau
Antonio Moreau
ATM RECYCLINGSYSTEMS GMBH
Avant-Garde
Axxess
Balance G.T.R. Inc.
Balances Industrielles Montréal Inc.
Banque de Montréal
Bazinet Robert & Fils
Bell 1896276
Bell Mobilite
Brulerie De Café De Granby
Cables Ben-Mor Inc.
CCI Premiers soins
Centre Du Camion Ste-Marie
Chagnon et fils inc.
Cintas Canada Ltée
Claude G. Installations
Coopérative Régionale d'électricité
D M Goos Dielsel Inc.
Démarreur Granby Enr.
Dicom Express
Distribution Upton Inc.
Drillmex Inc.
Ducharme & Frère Inc.
Edm Transport
Employés
Entreprises Desjardins & Fontaine Ltée
Entreprises SRM Leblanc
Estrifab Inc.
Excellence Hydraulique Inc.
Fibre Noir
Francois Allard
G&K SERVICES CANADA
Garage Morin
Gauvin Equipements
Granby Oxygene (1989)
Groupe Maska
Groupe Page Jaune
Groupe R.Y.
Imprimerie Dumaine Inc.
Lawson Products Inc.
Le Travailleur Plus
Legault Metal
1627 Boul Bastien; Québec QC G2K 1H1
7405 Duplessis; St-Hyacinthe QC J2R 1S5
Josef-Ressel-Gasse 8, 8753 Fohnsdorf, AUSTRIA
104-A Chemin Du Tremblay; Boucherville QC J4B 6Z6
360 St-Jacques O 12e Étage; Montréal QC H2Y 1P5
155 Boul Industriel; Châteauguay QC J6J 4Z2
2717 Ave Dollard; Lasalle QC H8N 2J8
Att: Michel Masson; 105 St-Jacques, 5e étage; Montréal QC H2Y 1L6
585 Principale; Laprésentation QC J0H 1B0
CP 8712 Succ Centre-Ville; Montréal QC H3C 3P6
CP 11095 Succ Centre-Ville; Montréal QC H3C 5E7
623 rue Philippe-Kennes; Granby QC J2H 0C9
1105 rue Lemire; St-Hyacinthe QC J2T 1L8
4670 Boul Pie IX; Montréal QC H1X 2B5
54000 Martineau; St-Hyacinthe QC J2R 1T8
1304 Principale; St-Dominique QC J0H 1L0
1470 Nobel; Boucherville QC J4B 5H3
201-1 Laval Sud; Granby QC J2G 7H7
3113 rue Principale; Saint-Jean-Baptiste QC J0L 2B0
107 Route 235; Ange-Gardien QC J0E 1E0
901 Dufferin; Granby QC J2H 0T7
CP1117 Succ Centre-Ville; Montréal QC H3C 5H3
295 Principale; Upton QC J0H 2E0
2105 Bombardier; Ste-Julie QC J3E 2N1
53 rue Sainte-Cécile; Saint-Pie QC J0H 1W0
63 Bessette; Québec QC G1B 1R7
1735 Lavoisier; Ste-Julie QC J3E 1Y6
8030 Boul Laframboise; St-Hyacinthe QC J2R 1G7
100 Robinson O; Shefford QC J2M 1G7
1780 Marie-Victorin; St-Bruno QC J3V 6B9
550 Ave Beaumont Suite 320; Montréal QC H3N 1V1
5240 Grandmont; Drummondville QC J2E 1L7
Dept 400004 PO Box 4372 Stn A; Toronto ON M5W 0J2
357 Notre-Dame; St-Pie QC J0H 1W0
1100 Louis-Marchand; Beloeil QC J3G 6S3
461 rue Robinson Sud; Granby QC J2G 7N3
550 De Vaudreuil; St-Hyacinthe QC J2S 4H2
CP11788 Succ Centre-Ville; Montréal QC H3C 0C2
1400 Boul Pierre-Rioux Est; Victoriaville QC G6T 2T7
5350 Ave Trudeau; St-Hyacinthe QC J2S 7Y8
7315 Rapistan Court; Mississauga ON L5N 5Z4
309 Principale; Granby QC J2G 2W3
CP 518; Amos QC J9T 3A8
Montant/Amou
nt
($)
1,896,225.26
1,896,225.26
21,256.08
21,256.08
460.00
178.92
8,724.00
431.16
945.00
494.39
2,506.46
1,103,220.94
1,231.42
148.77
2,474.39
163.07
367.75
224.96
55.86
1,045.38
253.65
1,428.77
9,368.03
466.69
55.19
190.61
4,828.96
453.90
441.20
5,826.60
4,146.02
1,789.54
331.13
75.00
549.79
1,839.60
6,302.36
886.50
3,954.64
4,327.07
1,591.75
1,615.61
1,164.14
569.13
403.56
Inconnu/Unknown
489.86
4,126.45
PricewaterhouseCoopers Inc.
Liste des créanciers / List of Creditors
dans l'affaire de la faillite de / In the matter of the Bankruptcy of
7828659 Canada Inc.
(Groupe Métaux Picard - Métaux Picard & Fille - Picard Scrap Metal Group)
Nom/Name
Adresse/Address
Les Carrières
700 Principale; St-Dominique QC J0H 1L0
Les Pétroles O. Archambault & fils inc.
39A, rang Amyot Est; St-Denis-sur-Richelieu QC J0H 1K0
Liebherr Canada Ltée
4250 Chomedy Highway Suite 13; Laval QC H7R 6E9
Linde Canada
PO Box 11451; Montréal QC H3C 5K3
Location Hewitt Inc.
Case Postale 700; Pointe-Claire QC H9R 4S8
Madame Lave-Tout
558 Principale; St-Dominique QC J0H 1L0
Nutrition Animal St-Pie
59 Avenue Roy; St-Pie QC J0H 1W0
Oleum Technologies Inc.
2685 rue Galt Ouest; Sherbrooke QC J1K 1L8
Papeterie Atlas
32 Boul Pie IX; Granby QC J2G 9G9
Petro Canada
619 St-Laurent; Granby QC J2G 8Y3
Plomberie et chauffage Saint-Hyacinthe
585 Brodeur; St-Hyacinthe QC J2S 4J6
Produits Industriels Laliberté
2155 Sigouin; Drummondville QC J2C 6T4
Purolator
PO Box 7006 31 Adelaide St East; Toronto ON M5C 3E2
Remorquage Loyer & Fils Inc.
4225 Rang De La Rivière Sud; St-Jean-Baptiste QC J0L 2B0
Roger Desmarais Distribution
554 Grand Rang St-Francois; St-Pie QC J0H 1W0
Sectek
580 Ontario Est; Montréal QC H2L 0B6
Securime
1251 Boul St-Joseph Est Bureau 101; Montréal QC H2J 1L9
Sonic
4050 Boul Matte; Brossard QC J4Y 2Z2
Soudure St-Pie
199 St-Francois; St-Pie QC J0H 1W0
Sylvestre & Associés
Cabinet d'avocats; 1600 Girouard O, Bureau 236; St-Hyacinthe QC J2S 2Z8
Synairtech
5855 rue Lamoureux; St-Hyacinthe QC J2R 1S3
Telecom
135 Boul De Mortagne Suite E; Boucherville QC J4B 6G4
Telecoms
136 Boul De Mortagne Suite E; Boucherville QC J4B 6G4
Zus Axxess
360 St-Jacques O 12e V étage; Montréal QC H2Y 1P5
Zus CN Wagons
17550 South Ashland Ave, Homewood, IL 60430 USA
Zus CN Wagons
Co-ordinator CAR accounts; P.O. Box 8100, Montreal QC H3C 3N4
Total Créanciers non garantis/Unsecured Creditors
GRAND TOTAL
Montant/Amou
nt
($)
658.65
5,210.41
9,933.00
2,765.99
83.18
494.50
506.93
439.20
890.44
922.23
350.79
856.61
339.04
402.41
354.00
327.68
70.02
399.28
45.99
801.68
267.15
14.89
1,147.15
2,835.00
5,062.27
0.00
1,215,326.71
3,132,808.05
Reserved for Administration
Secured :
Privileged :
Unsecured :
Original:
PROOF OF CLAIM
(see instructions on page 3)
IN THE MATTER OF THE BANKRUPTCY OF:
Amendment:
Initials
Collocated on:
7828659 Canada Inc., doing business under the names of Groupe Métaux Picard, Métaux Picard & Fille and Picard Scrap Metal Group, of
the city of Saint-Pie, province of Quebec (referred to in this form as “the debtor”)
and the claim of
, (referred to in this form as “the creditor”).
All notices or correspondence regarding this claim must be forwarded to the creditor at the following address:
(attention)
(civic number and street)
(city, province, postal code and country)
Telephone:
Fax:
Email address:
I,
residing in the city of
(name of individual completing this form)
in the Province of
If an officer of the company, state
position or title.
, do hereby certify that:
1.
 I am the creditor of the above-named debtor or  I am
of
2.
The attached statement of account or
affidavit must specify the vouchers
or other evidence in support of the
claim.
3.
Check and complete the appropriate
category.
4.
I have knowledge of all the circumstances connected with the claim referred to below.
The debtor was, at the date of bankruptcy, namely the 27th day of April 2016, and still is, indebted to the
creditor in the sum of $
, as specified in the statement of account
(or affidavit) attached and marked Schedule “A”, after deducting any counterclaims to which the debtor is
entitled.
A
Check appropriate description. Set
out an attached sheet details to
support priority claim.
Give full particulars of the claim,
including the calculations upon
which the claim is based.
(name of creditor or its representative)
(state position or title)
.
B

Unsecured claim of $
(Other than a customer contemplated by Section 262 of the Act). In respect of this debt,
I do not hold any assets of the debtor as security and:
(i)
 Regarding the amount of $
(ii)
 Regarding the amount of $
, I claim a right to a priority under section
136 the Act.
Claim of lessor for disclaimer of a lease of $
.
I hereby make a claim under subsection 65.2(4) of the Act, particulars of which are as follows:

, I do not claim a right to a priority.
.
Give full particulars of the security,
including the date on which the
security was given and the value at
which you assess the security, and
attach a copy of the security
documents.
C
Attach a copy of sales agreement and
delivery receipts.
D

Claim by farmer, fisherman, or aquaculturist of $
I hereby claim under subsection 81.2(1) of the Act for the unpaid amount of $
.
.
Give full particulars of any wage
earner’s claim, including the
calculations upon which the claim is
based.
E

(i)
or
(ii)
Claim by wage earner of $
 I hereby make a claim under subsection 81.3(8) of the Act in the amount of $
.
 I hereby make a claim under subsection 81.4(8) of the Act in the amount of $
.
Give full particulars of any
employee’s claim, including the
calculations upon which the claim is
based.
F

(i)
or
(ii)
Claim by employee for unpaid amount regarding pension plan of $
 I hereby make a claim under subsection 81.5 of the Act in the amount of $
,
 I hereby make a claim under subsection 81.6 of the Act in the amount of $
.
To be completed when a proposal
provides for the compromise of
claims against directors. Give full
particulars of the claim, including
the calculations upon which the
claim is based.
G

Claim against director of $
.
I hereby make a claim under subsection 50(13) of the Act, particulars of which are as follows:
Give full particulars of the claim,
including the calculations upon
which the claim is based.
H

Secured claim of $
In respect of this debt, I hold assets of the debtor valued at $
as security, particulars of which are as follows:
.
.
.

Claim of a customer of a bankrupt securities firm of $
.
I hereby make a claim as a customer for net equity as contemplated by section 262 of the Act,
particulars of which are as follows:
.
Chose the right formulation for your
situation by checking it and striking
the non desired portion.
5. To the best of my knowledge,  I or  the above-named creditor  am/is or  am/is not related to the
debtor within the meaning of section 4 of the Act, and  have/has or  have/has not dealt with the debtor
in a non-arm’s-length manner.
Provide details of payments, credits
and transfers at undervalue.
6. The following are the payments that I have received from, the credits that I have allowed to, and the transfers
at undervalue within the meaning of subsection 2(1) of the Act that I have been privy to or a party to with the
debtor within the three months (or, if the creditor and the debtor are related within the meaning of section 4
of the Act or were not dealing with each other at arm’s length, within the 12 months) immediately before the
date of the initial bankruptcy event within the meaning of subsection 2(1) of the Act:
.
Applicable only in the case of the
bankruptcy of an individual.
7.  I request that a copy of the report filed by the trustee regarding the bankrupt’s application for discharge
pursuant to subsection 170(1) of the Act be sent to the above address.
Must be signed and witnessed.
8.
Notes:
DATED AT______________________this _____th day of
, 201_____.
(signature of witness)
(signature of individual completing this form)
(name of witness, print)
(name of individual completing this form, print)
All references to “the Act” refer to the Bankruptcy and Insolvency Act.
If an affidavit is attached, it must have been made before a person qualified to take affidavits.
If a copy of this form is sent electronically by means such as email, the name and contact information of the sender, prescribed in Form 1.1,
must be added at the end of the document.
Warnings: A trustee may, pursuant to subsection 128(3) of the Act, redeem a security on payment to the secured creditor of the debt or the value of
the security as assessed, in a proof of security, by the secured creditor.
Subsection 201(1) of the Act provides severe penalties for making any false claim, proof, declaration or statement of account.
If there are any questions in completing the proof of claim, please write or call the office of the trustee.
PricewaterhouseCoopers Inc.
LICENSED INSOLVENCY TRUSTEE
1250 René-Lévesque Boulevard West, Suite 2500
Montréal, Quebec H3B 4Y1
Attention: Mrs. Julie Brunet
Telephone: 514-205-5001 ext. 1460
Fax: 514-205-5694
Email: [email protected]
GENERAL PROXY
I,
hereby appoint
, of
(name of creditor)
, a creditor in the above matter,
(name of town or city)
, of
(name of proxy)
(company or firm)
, to be my proxy
holder in the above matter, except as to the receipt of dividends,  with power to appoint another proxyholder in his or her place or  without power
to appoint another proxyholder in his or her place.
DATED AT
, this
th
day of
,201
(Signature of witness)
(Signature of the creditor or its authorized representative)
(Name of witness, print)
(Name of creditor of the creditor or its authorized representative, print)
.
2
Instructions for completing proof of claim forms
Every creditor shall prove his claim, and a creditor who does not prove his claim is not entitled to share in any distribution of the amounts from the
realization of the assets. Claims not completed correctly in every respect will be returned.
In completing the attached form, your attention is directed to the marginal notes on the form and to the following requirements:
Proof of Claim:
1.
The form must be completed and signed by an individual and not by a corporation. If you are acting for a corporation or other person, you must
state the capacity in which you are acting, such as, Credit Manager, Treasurer, Authorized Agent, etc.
2.
The person signing the form must have knowledge of the circumstances in connection with the claim.
3.
The date appearing at this paragraph is the one at which amounts owed are to be calculated. A Statement of Account containing details of the claim
as well as the correct name of the debtor must be attached and marked “A”.
4.
The nature of the claim must be indicated by ticking the type of claim which applies, e.g. ticking the box:
A
indicates the claim is unsecured and
indicates that the creditor is not claiming any priority
indicates the creditor is claiming preferred status under section 136 of the Act. Details to support the priority claim must be set out on an
attached schedule.
B
indicates a claim of landlord for disclaimer of a lease under subsection 65.2(4) of the Act. Details to support this claim must be set out on an
attached schedule.
C
indicates the claim is secured and the value at which the creditor assesses the security must be inserted. Details of each item of security held
should be attached as a separate schedule and submitted with a copy of the chattel mortgage, conditional sales contract, security agreement,
etc.
D
indicates that the creditor is a farmer, fisherman or aquaculturist who supplied goods within fifteen (15) days prior to the date of
receivership or bankruptcy and has not yet been paid for those goods.
E
E(i)
indicating that the creditor is a former employee of the debtor:
The claim of a clerk, servant, travelling salesperson, labourer or worker who is owed wages, salaries, commissions or compensation by a
bankrupt for services rendered during the period beginning on the day that is six (6) months before the date of the initial bankruptcy event
and ending on the date of the bankruptcy is secured, as of the date of the bankruptcy, to the extent of $2,000 — less any amount paid for
those services by the trustee or by a receiver — by security on the bankrupt’s current assets on the date of the bankruptcy.
E(ii)
The claim of a clerk, servant, travelling salesperson, labourer or worker who is owed wages, salaries, commissions or compensation by a
person who is subject to a receivership for services rendered during the six (6) months before the first day on which there was a receiver in
relation to the person is secured, as of that day, to the extent of $2,000 — less any amount paid for those services by a receiver or trustee —
by security on the person’s current assets that are in the possession or under the control of the receiver.
F
indicates the claim by employee for unpaid amount regarding pension plan under subsection 81.5 and 81.6 of the Act. Details to support this
claim must be set out on an attached schedule:
under subsection 81.5 of the Act, if it is a Bankruptcy
under subsection 81.6 of the Act, if it is a Receivership
Details to support this claim must be set out on an attached schedule.
A(i)
A(ii)
F(i)
F(ii)
G
indicates the claim is against a director under subsection 50(13) of the Act. It is applicable only in the case of a proposal which provides for
the compromise of claims against directors. Details to support this claim must be set out on an attached schedule.
H
(applies only to bankruptcies of security firms) indicating that the creditor is a customer of the bankrupt securities firm.
5.
The person signing the form must indicate (by checking the appropriate box and striking out what is not applicable) whether the creditor and the
debtor are related. Section 4 of the Act defines persons related to a debtor. If the creditor is related by blood or marriage to the debtor, the creditor
should consider itself to be a related person. If the debtor is a corporation, a creditor would be related if it was a shareholder or if the creditor was
controlled by the same shareholders as the debtor.
6.
The person signing the form must provide full details of all payments and credits received from or allowed to the debtor during the period indicated.
Leaving a blank will indicate that there were no such payments and credits.
7.
In the case of the bankruptcy of an individual, tick the box if desired.
8. The person signing the form must insert the place and date and the signature must be witnessed.
General Proxy:
If it is desired to appoint a proxy, the proxy form must be completed and signed by the creditor; if the creditor is a corporation, the proxy form must be
signed by an authorized representative (who is not necessarily the individual signing the proof of claim form) and must be witnessed.
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