FORM 72F

INITIAL INVENTORY

Exhibit "A" to the Affidavit of [name] ,

SWORN (or Affirmed) before me in the (City, Town, etc.) of , in the Province of , on (date).

Commissioner for Oaths

(or as may be)

1.	ASSETS

Real estate:	[legal descriptions or civic addresses]

Vehicles:	[make, model year and serial number]

Bank accounts

and cash on hand:	[account numbers and balances]

R.R.S.P.'s:	[amount and place of deposit or name of trustee]

Household furniture,

appliances, etc.:	[brief physical description and estimate of value]

Stocks and bonds:	[estimate of value and place of deposit]

Monies owed

to respondent:	[estimate of amounts and names of debtors]

Life insurance:	[value of benefits recoverable on death, names of insurers and policy numbers]

Pension plans:	[estimate of pension entitlement and name of trustee]

Other:	[specify]

2.	LIABILITIES

Liability	Creditor	Balance Owing

Mortgage:

Bank loans:

Finance company loans:

Department store accounts:

Credit cards:

Other

(specify):

3.	INCOME

Source	Amount	Frequency

(monthly, yearly, etc.)