Form 4—Notice by Debtor Company to Disclaim or Resiliate an Agreement

To space to insert monitor and parties to the agreement, (monitor and parties to the agreement)

Take notice that

1. Proceedings under the Companies' Creditors Arrangement Act ("the Act") in respect of space to insert name of debtor company (name of debtor company) were commenced on the space to insert day day of space to insert month, 20space to insert year.

2. In accordance with subsection 32(1) of the Act, the debtor company gives you notice of its intention to disclaim or resiliate the following agreement (provide sufficient details of the agreement to enable it to be identified):

space to insert details, line 1

space to insert details, line 2

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3. In accordance with subsection 32(2) of the Act, any party to the agreement may, within 15 days after the day on which this notice is given and with notice to the other parties to the agreement and to the monitor, apply to court for an order that the agreement is not to be disclaimed or resiliated.

4. In accordance with paragraph 32(5)(a) of the Act, if no application for an order is made in accordance with subsection 32(2) of the Act, the agreement is disclaimed or resiliated on the space to insert day day of space to insert month, 20space to insert year, being 30 days after the day on which this notice has been given.

Dated at space to insert city, space to insert province, on space to insert day and month, 20space to insert year.

space to insert signature of debtor company
Debtor Company

The monitor approves the proposed disclaimer or resiliation.

Dated at space to insert city, space to insert province, on space to insert day and month, 20space to insert year.

space to insert signature of monitor's representative responsible for the proceedings
Monitor's representative
responsible for the proceedings

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