CAP. 61
Bankruptcy.
CONTINGENT OR OTHER LIABILITIES.
(FULL PARTICULARS of all liabilities not otherwise scheduled to be given here.)
No. Name of creditor or claimant. Address and occupation. Amount of liability or claim. Amount expected to rank for dividend. Date when liability incurred. Nature of liability. Month. Year. $ $Dated this day of 19
F.
(Signature)
CREDITORS FOR RENT, ETC., RECOVERABLE BY DISTRESS.
Period No. Name and Address of creditor. Occupation. Nature of claim. Date during which claim accrued. when due. Amount of claim. Amount recoverable by distress. Difference ranking for dividend (to be carried to List A.). $Dated this day of 19
G.
(Signature)
PREFERENTIAL CREDITORS FOR RATES, TAXES, AND WAGES.
No. Name and Address of creditor. Occupation. Nature of claim. Period during which claim accrued. Date when due. Amount of claim. Amount payable in full. Difference ranking for dividend (to be carried to List A.). $ $ $Dated this day of 19
436