PDF version
55 KB, 2 pages
(Subsections 68(6), 68(7) and 170.1(1) of the Act)
(Title Form 1)
I, , trustee of the estate of , a bankrupt, who made an assignment (or against whom a bankruptcy order was made) on the day of , hereby apply to the official receiver to refer this matter to the mediator, who shall set the time and place for the mediation.
This application for mediation is being made for the following reasons:
(Check appropriate description(s))
- Subsection 68(6) – There is disagreement as to the amount of surplus income to be paid by the bankrupt.
- Subsection 68(7) – There is a written request from , a creditor, (creditor's address), to proceed with the mediation process.
- Subsection 170.1(1) – The trustee is opposed to the discharge of the bankrupt on a ground referred to in paragraph 173(1)(m) or (n) of the Act.
- Subsection 170.1(1) – , a creditor, (creditor's address), is opposed to the discharge of the bankrupt on a ground referred to in paragraph 173(1)(m) or (n) of the Act.
An income and expense statement of the bankrupt is attached to this request (Form 65).
(Indicate names, mailing addresses, phone numbers and email addresses of all parties, including the trustee’s representative (if applicable))
(Provide details (names and estate number) of any related estate file requiring concurrent mediation (e.g., spousal file))
(Check applicable box(es))
Has a Mediation Settlement Agreement (Form 63) been reached by the parties?
Yes
No
If "yes,"
i) Has the Mediation Settlement Agreement (Form 63) been signed by the parties?
Yes, and a copy of the signed settlement agreement is attached to this request.
No, but details pertaining to the settlement agreement (draft – Form 63) are attached to this request.
ii) Are you willing to proceed with this mediation via email, if applicable? Footnote 1
Yes
No
Dated at , this day of .
Licensed Insolvency Trustee