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(Subsections 63(1) and 63(6) of the Act)
In the 
Court of (province) in Bankruptcy
In the matter of the proposal of , a debtor
On the application of , the trustee acting in the proposal of (or , a creditor of) ; on reading the application of that trustee (or creditor); on hearing ; and as it appears that
(Check appropriate description)
has defaulted in the performance of a provision in the proposal.
the proposal cannot continue without injustice or undue delay.
the court's approval of the proposal was obtained by fraud.
has been convicted of the following offence under the Act, namely, 
.
It is ordered that the proposal approved by order made on the 
day of 
, is hereby annulled.
It is further ordered that the insolvent person is deemed, pursuant to subsection 63(4) of the Act, to have hereupon made an assignment of their property and that the property is vested in , the trustee.
(In the case of a proposal by a bankrupt, the previous paragraph is to be replaced by the following:)
It is further ordered that the property vested in the bankrupt by the order approving the proposal is revested in , the trustee.
Dated at , this day of .
Judge or Registrar