In the Court of

of

(County, Judicial Centre or District, or as the case may be)

AFFIDAVIT

I, , of in the Province of make (oath or solemn affirmation) and say that:

• 1 The following is a complete and full statement of all my assets and liabilities and of my personal responsibilities.

• 2 All of my creditors and the amounts owing by me to them are as follows:

  	Name	Address	Relationship to Debtor	Amount	Date Debt Incurred
  1
  2
  3
  4
  5
  6
  7
  8
  9
  10

• 3 My creditors hold security as follows:

  Name of Creditor		Nature and Particulars of Security

• 4 I have an interest in the following described property:

  Description	Value	Encumbrances
  	$	$
  	$	$
  	$	$

• 5 My total income from all sources amounts to $  being .

• 6 My take home income is $  after the following deductions .

• 7 My business or occupation is and I am employed by whose address is .

• 8 My age is .

• 9 I am (a spouse, a common-law partner or single).

• 10 The income of my (spouse or common-law partner) from all sources amounts to $ , being .

• 11 The take home income of my (spouse or common-law partner) is $  after the following deductions:

  

  .

• 12 The business or occupation of my (spouse or common-law partner) is that of and my (spouse or common-law partner) is employed by whose address is .

• 13 I have been unemployed during the past 12 months for a period of because of

  

  (state reason for unemployment)

• 14 The following persons are dependent upon me:

  Name	Age	Relationship	Extent of Dependency

• 15 The monthly living expenses for myself and my dependants are:

  Food	$
  Rent or house payment	$
  Utilities	$
  Clothing	$
  Drugs	$
  Transportation	$
  Insurance	$
  Incidentals	$
  Other	$
  Total	$

(Sworn or affirmed) before me at , in the Province of , this day of , 20.

Debtor

(Title of Court and style of cause as in Form 1)

NOTICE TO CREDITORS

Date

To

Re

Debtor

TAKE NOTICE that the above named person has applied for a consolidation order under the Orderly Payment of Debts provisions of Part X of the Bankruptcy and Insolvency Act and has, by affidavit filed in this court, given the following information:

Creditors of the Debtor		Relationship to Debtor	Date Debt Incurred	Amount
1				$
2				$
3				$
4				$
5				$
6				$
7				$
8				$
9				$
10				$

The following creditors hold security as follows:

Creditors		Nature and Particulars of Security

Property by Debtor	Value	Encumbrances
	$
	$

Income of		Source of Income
Debtor	$
Spouse or common-law partner Debtor	$
From other sources	$
Total	$	(per month)

The Debtor has the following Dependants:

Name	Age	Relationship	Extent of Dependency

The Debtor has the following living expenses:

Food	$
Rent	$
Utilities	$
Clothing	$
Drugs	$
Transportation	$
Insurance	$
Incidentals	$
Total	$ (per month)

The clerk has settled that the amount of $  (weekly or monthly) be paid into court by the debtor to be distributed pro rata among the creditors once every three months.

If you have any objection to the amount as acknowledged as owing to you or any creditor, or to the manner of, or the amount of payment, or to any of the facts set out above, return the attached form to the court within twenty days from the date hereof, stating fully your objections. Any objections will be heard by the clerk at his office in the Court House at on the day of 20 at the hour of . You will, prior to that date, be notified of any objections filed by other creditors in connection with the application.

If you do not file any objection within the time stated, the amount acknowledged as owing to you by the debtor will become a judgment of the court in full settlement of his debt, and the manner of payment will become an order of the court.

NOTE: If the debt as acknowledged to you is secured, you may, at any time, elect to rely on your security in the manner provided for in section 232 of the Act, a copy of that section being set out below:

• “232. (1) A registered creditor holding security for a claim may, at any time, elect to rely on his security notwithstanding that the claim is included in a consolidation order.

• (2) Where the proceeds from the disposal of the security referred to in subsection (1) are in excess of the registered creditor’s claim, the excess shall be paid into court and applied in payment of other judgments against the debtor.

• (3) Subsection (2) does not apply where the security is in the form of chattels exempt from seizure under any law in force in the province in which the consolidation order was issued.

• (4) Where the proceeds from the disposal of the security referred to in subsection (1) are less than the registered creditor’s claim, the creditor remains entitled to the balance of his claim.

• (5) Subsection (4) does not apply in a case where, under the law in force in the province in which the consolidation order was issued, a creditor

  • (a) who enforces his security by repossession or repossession and sale, or

  • (b) who seizes and sells the security under an execution issued pursuant to a judgment obtained against the debtor in respect of the claim so secured,

  is limited in his recovery of the claim to the security so repossessed or the proceeds of the sale thereof.”

If you elect to rely on your security, you must immediately place a fair value on the goods so repossessed and notify the court of this valuation at once.

If the value exceeds the amount owing to you, then you are ordered to pay the excess of that value upon realization as to which you are required to exercise due diligence.

Clerk of the Court.

In the Court of

(County, Judicial Centre or District, or as the case may be)

of

In re Debtor

NOTICE OF OBJECTION

Date

To the Clerk of the Court

Court House

(location)(Province)

TAKE NOTICE that I object to the settlement made by you in this matter for the following reasons:

DATED this day of 20

Creditor

(Title of Court and style of cause as in Form 3)

To

NOTICE OF HEARING

TAKE NOTICE that an objection has been filed herein by

(or if objection is to another creditor’s claim, specify)

to the claim of

You are therefore required to attend

You may attend

before the Clerk of the Court on the day of 20 at the hour of in the Court House at at which time the objections will be heard and disposed of.

DATED this day of 20

Clerk of the Court

CONSOLIDATION ORDER NO

In the Court of

(County, Judicial Centre or District, or as the case may be)

of

In re Debtor

NOTICE OF MOTION

TAKE NOTICE that an application will be made by to the presiding judge in court (or the presiding judge in chambers, or as the case may be) at the court house in the (city, town, etc.) of in the Province of on the day of 20 at the hour of for an order

determining the objection of

• (a) to the claim of

• (b) to the terms (or to the proposed terms, as the case may be) of the consolidation order;

• (c) to the method of payment of the claims by the debtor; or

• (d) that terms of payment by the debtor should be fixed;

or for such other order as seems just.

(If required by the clerk, add) AND FURTHER TAKE NOTICE that in support of the application will be read the affidavit of (the applicant)

filed, (and specify any other material to be used).

DATED AT the day of 20

(Clerk of the court, or other applicant.)

• To: (Names and addresses of creditors, and debtor, as the case may be, receiving notice)

(Title of Court and style of cause as in Form 5)

NOTICE OF MOTION

TAKE NOTICE that an application will be made by to the presiding judge in court (or the presiding judge in chambers, or as the case may be) at the court house in the (city, town, etc.) of in the Province of on the day of 20 at the hour of for an order

approving the provision of the consolidation order for payment in full of the registered debts over a period longer than three years, without the consent of the following creditors:

or for such other order as seems just.

(If required by the clerk, add) AND FURTHER TAKE NOTICE that in support of the application will be read the affidavit of (the applicant) filed, (and specify any other material to be used).

DATED at the day of 20

(Clerk of the Court, or other applicant.)

• To: (Names and addresses of creditors, and debtor, as the case may be, receiving notice)

(Title of Court and style of cause as in Form 5)

NOTICE OF MOTION

TAKE NOTICE that an application will be made by to the presiding judge in court (or the presiding judge in chambers, or as the case may be) at the court house in the (city, town, etc.) of in the Province of on the day of 20 at the hour of for an order

• Delete (a) or (b)

  (a) Authorizing the applicant to take on behalf of all the registered creditors such proceedings to enforce the consolidation order as the court deems advisable and after payment of the applicant’s costs in taking the proceedings to pay into court all monies recovered as a result of the proceedings, upon the grounds that

  • (i) the debtor is in default in complying with the consolidation order,

  • (ii) a further proceeding for the recovery of money has been brought against the debtor,

  • (iii) after the consolidation order made herein the debtor has incurred further debts totalling in excess of five hundred dollars,

  • (iv) a judgment in excess of one thousand dollars has been recovered against the debtor by who refuses to have his name added to the register, or

  • (v) the debtor has property (or funds) available for the satisfaction of the consolidation order,

or

• Delete all grounds that do not apply)

  (b) Permitting all the registered creditors to proceed each independently of the others for the enforcement of their claims under the consolidation order, upon the grounds that

  • (i) the debtor is in default in complying with the consolidation order,

  • (ii) a further proceeding for the recovery of money has been brought against the debtor,

  • (iii) after the consolidation order was made herein the debtor has incurred further debts totalling in excess of five hundred dollars,

  • (iv) a judgment in excess of one thousand dollars has been recovered against the debtor by who refuses to have his name added to the register, or

  • (v) the debtor has property (or funds) available for the satisfaction of the consolidation order,

  or for such other order as seems just.

(If required by the clerk, add) AND FURTHER TAKE NOTICE that in support of the application will be read the affidavit of (the applicant) filed, (and specify any other material to be used).

DATED at the day of 20

(Clerk of the Court, or other applicant).

• To: (Names and addresses of creditors, and debtor, as the case may be, receiving notice)

(Title of Court and style of cause as in Form 5)

NOTICE OF MOTION

TAKE NOTICE that an application will be made by to the presiding judge in court (or the presiding judge in chambers, or as the case may be) at the court house in the (city, town, etc.) of in the Province of on the day of 20 at the hour of for an order

granting the debtor continued relief under the consolidation order upon the grounds that the debtor’s default in making payments on the order is due to circumstances beyond his control,

or for such other order as seems just.

(If required by the clerk, add) AND FURTHER TAKE NOTICE that in support of the application will be read the affidavit of (the applicant) filed, (and specify any other material to be used).

DATED at the day of 20

(Clerk of the Court, or other applicant).

• To: (Names and addresses of creditors, and debtor, as the case may be, receiving notice)

(Title of Court and style of cause as in Form 5)

CONSOLIDATION ORDER NO .

Upon application of , debtor, and upon reading the affidavit of the debtor, filed, and upon hearing the debtor (and the registered creditors):

IT IS ORDERED (that the present circumstances of the debtor do not warrant the immediate settling of amounts of payment into court or the times of payment thereof, or) that the debtor pay to the Clerk of the

Court of , (centre)

of at 

on day of each and every week (or as the case may be) commencing day, the day of 20, the sum of $  to be distributed by the Clerk of the said court on a pro rata basis among the following registered creditors of the debtor, and among such other registered creditors as may be added to this order such payments to continue for a period of weeks (or as the case may be) until the claims outstanding herein have been satisfied.

	Date of Registration	Registered Creditor	Address	Amount of Debt
1				$
2				$
3				$
4				$
5				$
6				$
7				$
8				$
9				$
10				$

(If applicable)

IT IS FURTHER ORDERED (here insert terms as to custody of debtor’s property or disposition of proceeds from it).

(If applicable)

IT IS FURTHER ORDERED that the terms of payment extend over a period longer than three years without the consent of the following creditors:

DATED at this day of 20

Clerk (or judge) of the Court.

Amendments to Order

Date Particulars of AmendmentAmended by

(state if clerk or judge)

(Title of Court and style of cause as in Form 5)

CONSENT OF CREDITOR:

Date

To the Clerk of the Court

Court House

(Place)

I hereby consent to the issue of a Consolidation Order providing for the payment in full of the debts of the said debtor over a period longer than three years.

Creditor.

(Title of Court and style of cause as in Form  5)

To

NOTICE OF VARIATION OF CONSOLIDATION ORDER

TAKE NOTICE that on application of creditor (or debtor) and after a hearing held on day the day of 20, the consolidation order dated the day of 20 was confirmed.

set aside.

varied as follows:

DATED this day of 20

Clerk of the Court.

(Title of Court and style of cause as in Form 5)

To: , Debtor

REQUEST FOR ASSIGNMENT

TAKE NOTICE that you are required to give the Clerk of this Court an assignment to himself as Clerk of the Court of any monies due, owing or payable to you, or monies to become due, owing or payable to you, or earned or to be earned by you from .

DATED this day of 20

Clerk of the Court

(Title of Court and style of cause as in Form 5)

ASSIGNMENT

I, of hereby assign to the Clerk of the Court of (Province) of (Judicial, District, Centre or as the case may be) all moneys due, owing and payable to or to become due, owing and payable to or earned or to be earned by me from to be paid to the aforesaid Clerk in the manner and amounts as follows:

DATED this day of 20

Debtor

(Title of Court and style of cause as in Form 5)

To

NOTICE OF ASSIGNMENT

TAKE NOTICE that the above named debtor has by an assignment dated assigned to the Clerk of the Court of (Province), (Judicial, District,, Centre or as the case may be) of the sum of $  out of (here specify type of debt) and you are required to pay to the aforesaid Clerk the moneys owing from you to the debtor in the manner and amounts as follows:

DATED this day of 20

Clerk of the Court

(Title of Court and style of cause as in Form 5)

APPLICATION TO BE ADDED AS A CREDITOR

TAKE NOTICE that I hereby apply to be added to the register as a creditor of the above named debtor in the amount of $  being for

Creditor

(Title of Court and style of cause as in Form 5)

To

NOTICE OF ADDITIONAL CREDITOR

TAKE NOTICE that claims that he is entitled to be added to the register as a creditor of the above named debtor in the sum of $  being for

AND FURTHER take notice that unless an objection to this claim is filed with the Clerk, within twenty days from the date hereof, the creditor will be added to the register and be entitled to judgment for that amount.

DATED this day of 20

Clerk of the Court

(Title of Court and style of cause as in Form 5)

AFFIDAVIT

I, , of , in the Province of , make (oath or solemn affirmation) and say that:

• 1 I am a registered creditor of the debtor named in Consolidation Order No dated the day of , 20, and filed in this honourable Court.

• 2 I now elect to rely on the security I hold for my claim against the said debtor.

• 3 The security consists of and to the best of my knowledge and belief has a value of $ .

• 4 I make this affidavit in full knowledge of the fact that I am required to make full disclosure to the clerk of the court of any proceeds realized from the disposal of this security and to pay into court any proceeds in excess of my claim against the debtor.

(Sworn or affirmed) before me at , in the Province of , this day of 20

Debtor

ORDERLY PAYMENT OF DEBTS

(Title of Court and style of cause as in Form 5)

To

(Creditors)

NOTICE OF DEFAULT

TAKE NOTICE that as debtor is in default over 90 days on payment under Consolidation Order No dated the day of , 20, you are entitled to proceed forthwith, independently of all other creditors and without reference to the Court, for enforcement of your claim under the Consolidation Order.

DATED this day of 20

Clerk of the Court

(Title of Court and style of cause as in Form 5)

APPLICATION FOR FURTHER EXAMINATION OF DEBTOR

TAKE NOTICE that I hereby apply for a further examination and hearing (of the Debtor) in respect of (his/my) financial circumstances.

DATED this day of 20

(Creditor or Debtor)

(Title of Court and style of cause as in Form 5)

To

NOTICE OF FURTHER EXAMINATION

TAKE NOTICE that (Creditor or Debtor) has applied for a further examination and hearing of the debtor in respect of his financial circumstances.

You may appear

You are therefore required to appear before the clerk of the Court on the day of , 20 in the courthouse at at which time this further examination will be held.

DATED this day of 20

Clerk of the Court

[Repealed, SOR/92-578, s. 8]

[Repealed, SOR/89-158, s. 12]

The Court of

of

(Centre or District)

Date 20		Consolidation Order No.	Name of Debtor	Particulars (state if receipt or disbursement, etc.)	Receipt No.	✔	Amount Received		Bank				Cheque No.	✔
									Dr		Cr.

The Court of In re Consolidation Order No.

(Name of Debtor)

of

(District or Centre)

Date 20		Amount Received		Amount Distributed		Other Payments (fees, costs, postage, etc.)			Balance on hand		Disbursements to Creditors
											1		2		3		4		5		6		7		8		9		10
						Particulars	Entry				%		%		%		%		%		%		%		%		%		%

The Court of

of

(District or Centre)

Affidavit No.
Date 20	Property
Name of Debtor	Description	Value		Encumbrances
Address				Amount		Nature
Occupation
Name of Employer	Monthly Living Expenses — Per Affidavit of Debtor
Address				Total Expenses
Name of Debtor’s Spouse or Common-law Partner	Amendments			$
Address	Date	Details		$
Name of Spouse’s or Common-law Partner’s Employer				$
Address				$

Income

Income of Deponent, $ Source
Income of Spouse or Common-law Partner, $ Source
Total Income $ per
(State per week or month)
DEPENDANTS
Name	Relationship	Extend of Dependency	Court Fees Paid (including Costs of Hearings, if any)
			Date 20		Amount Received		Total