Schema documentation for Form78.xsd

Statement of Affairs (Business Bankruptcy) (Paragraph 158(d) of the Act)

Date of Bankruptcy

1. Sum of unsecured creditor liabilities from List A

2. Sum of secured creditor liabilities from List B

3. Sum of preferred creditor liabilities from List C

4. Sum of contingent, trust claims and other liabilities from List D

Total Liabilities (Sum of 1-4)

Surplus

Declaration of bankrupt sworn before commissioner Note: Now optional, choose RemoteBankruptDeclaration if sworn remotely

Name of person making sworn declaration

Declarant Given Names

Declarant Family or Company Name

Municipality Type where Signing was done

Name of the Municipality

Province for the Municipality

Signing Date

Name of commissioner for oaths or official receiver

Province in which the commissioner is licensed or the bankruptcy district of the official receiver

Remote Declaration of bankrupt sworn before commissioner Note: New optional field, only use if sworn remotely

Name of person making sworn declaration remotely

Name of commissioner for oaths or official receiver

Province in which the commissioner is licensed or the bankruptcy district of the official receiver

Declarant Given Names

Declarant Family or Company Name

Stated as being located at

Name of the Municipality stated at

stated at Province for the Municipality

1. Assets in inventory

2. Assets in trade fixtures etc.

3. Sum of good receivables from list E

3. Sum of doubtful receivables from list E

3. Sum of bad receivables from list E

3. Sum of estimated to produce from list E

3. Sum of Good, Bad, Doubtful and Estimated receivables

4. Sum of bills of exchange, promissory notes, lien notes, chattel mortgages etc. from List F

5. Sum of deposits in financial institutions

6. Sum of cash

7. Sum of value of livestock

8. Sum of value of machinery, equipment and plant

9. Sum of equity/surplus in real property from list G

10. Sum of value of furniture

11. Sum of value of RRSPs, RRIFs, life insurance etc.

12. Sum of value of securities (shares, bonds, debentures ...)

13. Sum of value of interests under wills

14. Sum of value of vehicles

15. Other Property description and value as per List H

Description of other property

Dollar value of other property

15. Sum of value of other property as per List H

Additional information if Bankrupt is a corporation

If a corporation, amount of subscribed capital

If a corporation, amount paid on capital

If a corporation, balance subscribed and unpaid on capital.

If a corporation, estimated to produce.

Whether or not a corporation, the total of above assets.

Deficiency amount

List A,  unsecured creditors details.

Name of this unsecured creditor

Address of creditor

Amount of this creditor's claim

List B, secured creditors details.

Name of this secured creditor

Address of creditor

Amount of this creditor's claim

Particulars of security

When given

Estimated value of security

Estimated surplus from security

Balance of claim unsecured

List C, a preferred creditor detail for wages, rents ...