No. 23. (Rule 39.)
STATEMENT OF AFFAIRS.
STATEMENT OF AFFAIRS on the
(Title.)
day of
19
+
the date of the Winding-up Order (or such other date as the Official Receiver has for special reasons directed).
I. As regards Creditors.
Gross Liabili- ties.
Liabilities.
Expected to rank.
C.
C.
Estimate
Assets.
to
produced
Debts and liabilities, viz:- (a)............... Unsecured 'Creditors' as per List
A" (State number).
(b). .Creditors
fully secured (not including debenture hol- ders), as
List "B"
per
Estimated value
of securities...
Estimated
surplus $ Carried to List
"0"
Balance to con-
tra (d)... $
(c)........Creditors partly secured,
as
"C"
per
List
$
Less estimated
value of securities
$ c.
Estimated to rank for
dividend
(a) Property as per List
H", riz :-
(a) Cash at bankers
(b) Cash in hand
(e) Stock in trade
(Estimated cost, $ (d) Machinery
>
(e) Trade fixtures, fit- tings, utensils, &c.... (f) Investments
shares, &c.
in
(g) Loans on mortgage (h) Other
viz:-
(b) Book debts (
property,
debtors), as per List
"I", viz:- Good
Doubtful
Bad...
Estimated to produce...
$ c.
(d) Liabilities on
(c) Bills
bills discounted other than the company's own acceptances for value, as per List D
+
Of which it is
expected will rank for divi- dond
(e) Other liabili- tics, as per List "E"
Of which it is expected will rank for divi- dend
(f)....Preferential i
creditors for
rat: 8,
taxes,
wages, Ac., as per List ""
deducted
tra
con-
$
(g) Loan on de-
benture bonds,
as per List "G"
deducted tra ( holders)
con-
C.
Estimated surplus (if any) after meeting liabilities of company, subject to cost of liquidation...
of ex-
change, or other
similar securi-
ties on
as
"J"
per
hand,
List
$ c.
Estimated to produce... (d) Surplus from securi- ties in the hauds of creditors fully secured (per contra) (b)
(e) Unpaid calls (
debtors), as per List "K
Estimated to produce...
Estimated total assets.. Deduct preferential creditors as per con- tra (/)
Estimated amount avail- able to meet claims of debenture holders...
Deduct loans on de- benture bonds secur- ed on the assets of the company as per contra (g)
Estimated amount avail- able to meet unsecured creditors, subject to cost of liquidation... Estimated deficiency of assets to meet liabilities of the company, subject to cost of liquidation
which is
The nominal amount of unpaid capital liable to be called up is $
[available to meet above deficiency] or [charged to debenture holders], or as the case may be.
C.