Debt Relief Worksheet (Page 3 of 10) in pdf

Debt Relief Worksheet Page 3

Debt Relief Worksheet

Page 3

RECENT TRANSACTIONS



Have you sold, disposed of, or transferred any assets in the past twelve months?

Yes

(including RRSP’s/Term Deposits/GIC’s and/or any other investments)

If yes, specify asset, approximate date, net proceeds and disposition of proceeds:

Have you made any large or lump sum payments in excess of regular payments to a



creditor in the past twelve months?

Yes

If yes, give details below:



Have you had any assets seized by any creditor within the past twelve months?

Yes

If yes, give details below:



Have you sold or transferred any property in the past five years while you knew yourself to be

Yes

insolvent, either in Canada or Elsewhere?

If yes, specify asset, approximate date, net proceeds and disposition of proceeds:

Have you made any gifts to a relative or other person that were of a value in



excess of $500.00 in the past five years?

Yes

If yes, give details below:



Have you received any lump sum payments or settlements in the last 12 months?

Yes

If yes, give details below.

IF YOU HAVE PAID ALIMONY OR MAINTENANCE PAYMENTS DURING THE PAST YEAR:

TO WHOM PAID?

AMOUNT PAID (YTD)

$_______________________

YES 

NO 

BY COURT ORDER?

Date of Court Order:

Debt Relief Worksheet Page 3