Form 2—Debtor Company Information Summary

(Commencement of Proceedings)

PDF/Word version


(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:

space to insert name, including names under which the debtor company carries on business, if any, line 1

space to insert name, including names under which the debtor company carries on business, if any, line 2

space to insert name, including names under which the debtor company carries on business, if any, line 3

2. Debtor company's head office address, telephone number and Web site address, if any:

space to insert debtor company's head office address

space to insert telephone number

space to insert Web site address

3. The debtor company is

Check box if debtor company is a not-for-profit body corporate a not-for-profit body corporate,

Check box if debtor company is an income trust an income trust, or

The debtor company is other (specify) other (Specify: space to insert type of debtor company)

4. Industry type code using the North American Industry Classification System:

space to insert industry type code using the North American Industry Classification System

5. Names and titles of directors and officers:

space to insert names and titles of directors and officers, line 1

space to insert names and titles of directors and officers, line 2

space to insert names and titles of directors and officers, line 3

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:

space to insert 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, line 1

space to insert 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, line 2

space to insert 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, line 3

7. Previous proceedings:

  • under the Bankruptcy and Insolvency Act: Check box if Previous proceedings are under the BIA yes Check box if previous proceedings are not under the BIA no

    If yes, estate number: space to insert, if yes, estate number

  • under the Companies' Creditors Arrangement Act: Check box if previous proceedings are under the CCAA yes Check box if previous proceedings are not under the CCAA no

    If yes, name of court, judicial district and court file number:

    space to insert, if yes, name of court

    space to insert, if yes, judicial district

    space to insert, if yes, court file number

  • foreign proceedings: Check box if this proceedings are foreign yes Check box if this proceedings are not foreign no

    If yes, country, name of court, judicial district and court file number:

    space to insert, if yes, name of court

    space to insert, if yes, judicial district

    space to insert, if yes, court file number

8. Are debtor company's shares or units publicly traded? Check box if debtor company's shares or units are publicly traded yes Check box if debtor company's shares or units are not publicly traded no

If yes, index symbol: space to insert, if yes, index symbol country:space to insert, if yes, country

9. Incorporation number, if applicable: space to insert incorporation number, if applicable

Check box if incorporation number is of federal nature Federal

Check box if incorporation number is of provincial nature Provincial (Specify: space to specify provincial incorporation number)

Check box if incorporation number is of other nature Other (Specify: space to insert other specification)

10. Are there companies that are affiliated with or subsidiaries of the debtor company?

Check box if there are companies that are affiliated with or subsidiaries of the debtor company yes Check box if there is no companies affiliated with or subsidiaries of the debtor compan no

If yes, names of affiliated and subsidiary companies:

space to insert, if yes, names of affiliated and subsidiary companies, line 1

space to insert, if yes, names of affiliated and subsidiary companies, line 2

space to insert, if yes, names of affiliated and subsidiary companies, line 3

11. Date of the most recent consolidated financial statements of debtor company:

space to insert year/space to insert month/space to insert day (yyyy/mm/dd)

12. The statements referred to in item 11 are:

Check box if the statements referred to in item 11 are audited audited (Name of auditor: space to insert name of auditor)

Check box if the statements referred to in item 11 are unaudited unaudited

13. Book values for the debtor company set out in the statements referred to in item 11:

  • Book value of total assets: $space to insert book value of total assets
  • Book value of total liabilities: $space to insert book value of total liabilities
    • secured: $space to insert amount secured
    • unsecured: $space to insert amount unsecured
    • trust claims: $space to insert trust claims
  • Book value of total liabilities that are contingent: $space to insert 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? Check box if the debtor company participates in prescribed pension plans for the benefit of its employees yes Check box if the debtor company do not participates in prescribed pension plans for the benefit of its employees no

If yes, give name of each plan and indicate whether it is a defined benefit or defined contribution plan:

space to insert, if yes, name of each plan and indicate whether it is a defined benefit or defined contribution plan, line 1

space to insert, if yes, name of each plan and indicate whether it is a defined benefit or defined contribution plan, line 2

space to insert, if yes, name of each plan and indicate whether it is a defined benefit or defined contribution plan, line 3

15. Name, address, telephone number and e-mail address of debtor company's legal counsel:

space to insert name of debtor company's legal counsel, line 1

space to insert address and telephone number of debtor company's legal counsel, line 2

space to insert e-mail address of debtor company's legal counsel, line 3

Part 2 — Information respecting monitor

16. Monitor's toll-free number for the proceedings, if any: space to insert monitor's toll-free number for the proceedings, if any

Monitor's Web page created for the proceedings, if any: space to insert monitor's Web page created for the proceedings, if any

17. Name, address, telephone number and e-mail address of monitor's legal counsel:

space to insert name of monitor's legal counsel, line 1

space to insert address and telephone number of monitor's legal counsel, line 2

space to insert e-mail address of monitor's legal counsel, line 3

Part 3 — To be completed if there is a foreign proceeding

18. Name of foreign representative:space to insert name of foreign representative

19. Country, name of court, judicial district and court file number:

space to insert country and name of court

space to insert judicial district

space to insert court file number

20. Indicate whether the proceeding is

Check box if  the proceeding is a foreign main one a foreign main proceeding, or

Check box if  the proceeding is a foreign non-main one a foreign non-main proceeding.

21. Date of first order in foreign proceeding: space to insert year/space to insert month/space to insert day (yyyy/mm/dd)

Dated at space to insert city, space to insert province, on space to insert day and month, 20space to insert year.

space to insert signature of monitor's representative responsible for the proceedings
Monitor's representative
responsible for the proceedings