Final Statement of Receipts and Disbursements (Other than Summary Administration and Consumer Proposals) (Section 152 of the Act) - Supplementary Identify the type of submission - Supplementary only An itemized list of receipts, excluding realization of assets. Eg.: Cash, miscellaneous... Itemize the receipts Sub-Total amount of that particular receipt grouping Expenses incurred to receive receipts. Realization of Assets Total Receipts Fees paid to the court / registrar Sum of Official Receiver Fees and Court Fees An itemized list of disbursements Eg.: Premiums, Auctioneer, Postage, miscellaneous... Itemize the disbursements Sub-Total amount of that particular disbursement grouping Trustee Remuneration Applicable taxes (Federal and Provincial) Type of Tax: PST, GST, HST Total tax amount of that type Extra information related to tax amount Total Applicable Taxes GST Tax Number for Quebec filings. Counselling Fees Applicable taxes for Counselling services Type of Tax: PST, GST, HST Total tax amount of that type Extra information related to tax amount Total Counselling Taxes Total Trustee's remuneration and GST, TPS and/or TVQ Total Disbursements Amount available for distribution Levy payable under section 147 The total of dividends and levies Proved Claim, Current and Interim Dividend and Levy information for secured creditors Amount of proved claims Sum of interim gross dividends, excluding current gross dividend Sum of interim levies, excluding current levy Sum of interim net dividends, excluding current net dividend Current gross dividend Current levy amount Current net dividend Percentage of Dividend Proved Claim, Current and Interim Dividend and Levy information for preferred creditors Amount of proved claims Sum of interim gross dividends, excluding current gross dividend Sum of interim levies, excluding current levy Sum of interim net dividends, excluding current net dividend Current gross dividend Current levy amount Current net dividend Percentage of Dividend Proved Claim, Current and Interim Dividend and Levy information unsecured creditors Amount of proved claims Sum of interim gross dividends, excluding current gross dividend Sum of interim levies, excluding current levy Sum of interim net dividends, excluding current net dividend Current gross dividend Current levy amount Current net dividend Percentage of Dividend Funds that have been returned to the Debtor Money sent back to OSB because it isn't worthy for distribution to creditors Status of the Debtor's discharge. Pick from list The date the Debtor's discharge status came into effect. Notes involved in this filing Date signed by the trustee Approved by the following inspectors Inspector Given Names Inspector Family Name Taxed at the sum of amount Taxed On Date Provide any additional information related to the form.