Report of Trustee (Subsections 171(1) and (2) of the Act) Name of trustee Location or company name of the trustee Name of bankrupt 1. Date of the assignment or date a receiving order was issued against the bankrupt or the date the bankrupt did file a proposal which subsequently was deemed to be an assignment 1. Name of previous trustee, if applicable 2. Bankrupt carried on business in this name 2. Bankrupt carried on business at this location 3. Residence of individual or principal place of business for a corporation 3. If bankrupt is a corporation, a list of directors and officers is mandatory Director of the corporation Officer of the corporation 4a. Persons who actively controlled the day to day operations or business of the bankrupt Name and address of the controlling persons Address Position of the controlling persons 4b. Persons who were responsible for, or under whose directions were incurred, the greater proportion of the bankrupts liabilities Name and Address of the responsible persons Address Position of the responsible persons 5. Opinion of trustee wrt satisfactory accounting and substantial disappearance of property The deficiency between the assets and the liabilities of the debtor has (or has not) been satisfactorily accounted for If not satisfactory accounting, there is evidence of a substantial disappearance of property Declaration by trustee 6. Probable cause(s) of bankruptcy The probable cause of bankruptcy. Pick from list 6. If other was chosen, describe other probable cause 7a(i) State or name the source of information and verification thereof regarding active persons named in 4a. 7a(ii). State or name the source of information and verification thereof regarding active persons named in 4b. 7b. Basis of opinion on satisfactory accounting and on substantial disappearance of property in 5. Describe what facts or information and verification or investigation thereof. Trustee's declaration Provide any additional information related to the form.