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

The following information pertains to the order made on the initial application in respect of (name of debtor company):
	1.	Name of court, judicial district and court file number:
		__________
		__________
		__________
	2.	Date on which order is made: __________
	3.	Debtor company’s head office address, telephone number and Web site address, if any:
		__________
		__________
		__________
	4.	Names under which debtor company carries on business, if different from name set out above:
		__________
		__________
	5.	Name and Web site address of monitor:
		__________
		__________
		__________
	6.	Name, address, telephone number and e-mail address of monitor’s representative responsible for the proceedings:
		__________
		__________
		__________
	7.	Web page address created for the proceedings, if any:
		__________
		__________
Dated at , , on 20.
Monitor’s representative responsible for the proceedings

(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, including names under which the debtor company carries on business, if any:
		__________
		__________
		__________
	2.	Debtor company’s head office address, telephone number and Web site address, if any:
		__________
		__________
		__________
	3.	The debtor company is
		□ a not-for-profit body corporate,
		□ an income trust, or
		□ other (Specify: )
	4.	Industry type code using the North American Industry Classification System:
		__________
	5.	Names and titles of directors and officers:
		__________
		__________
		__________
	6.	Any other names used by the debtor company during the 24-month period before the making of the order on the initial application, including names under which the company carried on business:
		__________
		__________
		__________
	7.	Previous proceedings:
		•under the Bankruptcy and Insolvency Act: □ yes □ no
		If yes, estate number: __________
		•under the Companies’ Creditors Arrangement Act: □ yes □ no
		If yes, name of court, judicial district and court file number:
		__________
		__________
		__________
		•foreign proceedings: □ yes □ no
		If yes, country, name of court, judicial district and court file number:
		__________
		__________
		__________
	8.	Are debtor company’s shares or units publicly traded? □ yes □ no
		If yes, index symbol: country: __________
	9.	Incorporation number, if applicable:__________
		□ Federal
		□ Provincial (Specify: )
		□ Other (Specify: )
	10.	Are there companies that are affiliated with or subsidiaries of the debtor company?
		□ yes □ no
		If yes, names of affiliated and subsidiary companies:
		__________
		__________
		__________
	11.	Date of the most recent consolidated financial statements of debtor company:
		//(YYYY/MM/DD)
	12.	The statements referred to in item 11 are:
		□ audited (Name of auditor:)
		□ unaudited
	13.	Book values for the debtor company set out in the statements referred to in item 11:
		• Book value of total assets: $
		• Book value of total liabilities: $
			• secured: $
			• unsecured: $
			• trust claims: $
		• Book value of total liabilities that are contingent: $
	14.	Does the debtor company participate in any prescribed pension plans for the benefit of its employees? □ yes □ no
		If yes, give name of each plan and indicate whether it is a defined benefit or defined contribution plan:
		__________
		__________
		__________
	15.	Name, address, telephone number and e-mail address of debtor company’s legal counsel:
		__________
		__________
		__________
PART 2 — INFORMATION RESPECTING MONITOR
	16.	Monitor’s toll-free number for the proceedings, if any: __________
		Monitor’s Web page created for the proceedings, if any: __________
	17.	Name, address, telephone number and e-mail address of monitor’s legal counsel:
		__________
		__________
		__________
PART 3 — TO BE COMPLETED IF THERE IS A FOREIGN PROCEEDING
	18.	Name of foreign representative: __________
	19.	Country, name of court, judicial district and court file number:
		__________
		__________
		__________
	20.	Indicate whether the proceeding is
		□ a foreign main proceeding, or
		□ a foreign non-main proceeding.
	21.	Date of first order in foreign proceeding: //(YYYY/MM/DD)
Dated at , , on 20.
Monitor’s representative responsible for the proceedings

(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: __________
	2.	File number assigned by the Superintendent of Bankruptcy: __________
	3.	Date of the most recent consolidated financial statements for debtor company:
		//(YYYY/MM/DD)
	4.	The statements referred to in item 3 are:
		□ audited (Name of auditor:)
		□ unaudited
	5.	Book values for the debtor company set out in the statements referred to in item 3:
		•Book value of total assets: $
		•Book value of total liabilities: $
			•secured: $
			•unsecured: $
			•trust claims: $
		•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? □ yes □ no
		If yes, give name of each plan and indicate whether it is a defined benefit or defined contribution plan:
		__________
		__________
		__________
PART 2 — INFORMATION RESPECTING PROCEEDINGS
	7.	Was interim financing granted by court order under section 11.2 of the Act? □ yes □ no
		If yes,
		•amount of interim financing granted by court order: $ __________
		•amount drawn: $ __________
	8.	Was a compromise or arrangement sanctioned by the court? □ yes □ no
		If yes,
		•Date on which the compromise or arrangement was sanctioned by the court: //
		(YYYY/MM/DD)
		•Was the compromise or arrangement approved by the creditors before the initial application was made?
		□ yes □ no
		•Was the compromise or arrangement completed? □ yes □ no
	9.	Name of debtor company at time of monitor’s discharge:
		__________
		__________
PART 3 — TO BE COMPLETED IF THERE IS A FOREIGN PROCEEDING
	10.	Name of foreign representative:
	11.	Country, name of court, judicial district and court file number:
		__________
		__________
		__________
	12.	Indicate if the proceeding is a
		□ a foreign main proceeding, or
		□ a foreign non-main proceeding.
	13.	Date of first order in foreign proceeding: //(YYYY/MM/DD)
Dated at , , on 20.
Monitor’s representative responsible for the proceedings

	To , (monitor and parties to the agreement)
	Take notice that
1. Proceedings under the Companies’ Creditors Arrangement Act (“the Act”) in respect of (name of debtor company) were commenced on the day of , 20.
2. In accordance with subsection 32(1) of the Act, the debtor company gives you notice of its intention to disclaim or resiliate the following agreement (provide sufficient details of the agreement to enable it to be identified):
__________
__________
__________
3. In accordance with subsection 32(2) of the Act, any party to the agreement may, within 15 days after the day on which this notice is given and with notice to the other parties to the agreement and to the monitor, apply to court for an order that the agreement is not to be disclaimed or resiliated.
4. In accordance with paragraph 32(5)(a) of the Act, if no application for an order is made in accordance with subsection 32(2) of the Act, the agreement is disclaimed or resiliated on the day of , 20, being 30 days after the day on which this notice has been given.
Dated at , , on 20.
Debtor Company

The monitor approves the proposed disclaimer or resiliation.

Dated at , , on 20.

Monitor’s representative responsible for the proceedings