Form 76—Notice by Trustee Requiring Filing of Proof of Security

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Form 76

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(Subsection 128(1) of the Act)

Take notice that:

1. You are hereby required, pursuant to subsection 128(1) of the Act, to file with me a proof of claim and proof of security (security documents) relating to any security that you hold on the property of Space to insert name of bankrupt, a bankrupt, which property is described below:

(Describe the property.)

2. The proof of claim and proof of security must give full particulars of the security, including the date on which it was given and the value at which you assess it.

3. If you do not file with me a proof of claim and proof of security in respect of the property, within the 30 days after the day on which this notice is served I may, with leave of the court, sell or dispose of the property, free of your security.

4. A proof of claim in the required form is attached.

Dated at Space to insert city, this Space to insert day of month day of Space to insert month Space to insert year .

Space to insert trustee's signature
Licensed Insolvency Trustee