Form 21—Assignment for the General Benefit of Creditors

For persons to which the 2009 amendments apply

PDF version

Form 21

137 KB, 1 page

(Section 49 of the Act)

(Title Form 1)

This indenture made this Space to insert day  Space to insert month, 2Space to insert year,


Space to insert full legal name of debtor
(Insert the full legal name of the debtor)

Space to insert address of debtorSpace to insert address of debtorSpace to insert address of debtor
(Insert address of the debtor)

hereinafter called "the debtor"


Space to insert name of trustee
(Insert the name of the trustee)

hereinafter called "the trustee".

(Check applicable category)

check here if this is a natureal personNatural person

check here if this is a corporate or other legal entityCorporate or other legal entity


Whereas the debtor is insolvent and desires to assign and to abandon all his/her property for distribution
among his/her creditors, in pursuance of the Act,

This indenture witnesses that the debtor does hereby assign to the trustee all the debtor's property for the uses, intents and purposes provided by the Act.

Signed at the Space to insert day of Space to insert month and year, in the Province ofSpace to insert province,
in the presence of Space to insert name of witness.

Space to insert signature of witness
Space to insert date
Space to insert debtor or legal representative of the debtor
(or legal representative
of the debtor)


If the debtor is a corporation, a certified copy of the resolution of the board of directors must be attached to this document.

If the debtor is deceased, attach a copy of the Court Order.

If a copy of this Form is sent electronically by means such as email, the name and contact information of the sender, prescribed in Form 1.1, must be added at the end of the document.