Form 39—Certificate of Assignment

For persons to which the 2009 amendments do not apply

PDF version

Form 39

KB, 1 page

(Paragraph 57(b) of the Act)

District of:

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Division No.:

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Court No.:

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Estate No.:

Space to insert estate number

In the Matter of the Bankruptcy of:

Space to insert name of debtor

Space to insert name of trustee

Space to insert administration

Date of Bankruptcy:

Space to insert date of bankruptcy


Space to insert security

Date of Initial Bankruptcy Event:

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Meeting of Creditors:

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Space to insert name of chairman

Designated Person:

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Certificate of Assignment - Section 57

I, the undersigned, Official Receiver in and for this bankruptcy district, do hereby certify that:

  • a proposal in respect of the aforenamed debtor was filed under section 62 of the Bankruptcy and Insolvency Act;
  • the creditors, at a meeting held to consider the proposal, refused to accept the proposal and the debtor is thereupon deemed to have made an assignment.

The said trustee is required:

  • to provide to me, without delay, security in the aforementioned amount;
  • to send to all creditors, within five days after the date of the trustee’s appointment, a notice of the bankruptcy; and
  • when applicable to call in the prescribed manner, a first meeting of creditors, to be held immediately following the meeting held to consider the proposal or at the aforementioned time and place or at any other time and place that may be later requested by the Official Receiver.
Date: Space to insert day / Space to insert month / Space to insert year
Space to insert signature of official receiver
Official Receiver