Report on Cash-flow Statement by the Person Making the Proposal (Paragraphs 50(6)(c) and 50.4(2)(c) of the Act) Name of mangement, receiver, liquidator, etc. Name of insolvent person or company Date the attached statement of projected cash-flow of the insolvent person was prepared. Item considered in this projection related to note below A note describing the purpose of this projection Notes describing the probable and hypothetical assumptions The projection has been prepared solely for the purpose described in this note. Date and location signed Provide any additional information related to the form.