Form 47—Consumer Proposal

(Paragraph 66.13(2)(c) of the Act)

(Title Form 1)

I, , a consumer debtor, hereby make the following consumer proposal under the Act:

1. That payment of the claims of secured creditors be made in the following manner:

(Set out the terms of the proposal in respect of secured claims.)

2. That payment of all claims directed by the Act to be paid in priority to other claims in the distribution of my property be made in the following manner:

(Set out the terms of the proposal in respect of preferred claims.)

3. That payment of the fees and expenses of the administrator of the consumer proposal and payment of the fees and expenses of any person in respect of counselling given by this person pursuant to the Act be made in the following manner:

(Set out the terms of the proposal in respect of these fees and expenses.)

4. That the following payments be made to , the administrator of the consumer proposal, for the benefit of the unsecured creditors:

(Set out the schedule of payments and the total amount to be paid in respect of unsecured claims.)

5. That the administrator of the consumer proposal distribute the moneys received to the unsecured creditors in accordance with the following schedule:

(Describe the manner for distributing dividends.)

6. That the proposal may include the following additional terms:

(Set out the additional terms as proposed.)

Dated at , this day of .

Witness

Consumer Debtor

Note: 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.