Bankruptcy.
L.
IN SUBSTITUTION for such of the sheets named "A" to "J" as will have to be returned blank.
List
DEBTOR'S REMARKS.
Particulars, as per front sheet.
Where no particulars are entered by the debtor on any one or more of the lists named "A" to "J" the word "Nil" should be inserted in this column opposite the particular list or lists thus left blank.
B.
C.
D.
A.
Unsecured creditors
B.
Creditors fully secured
C.
Creditors partly secured
D.
Liabilities of debtor on bills discounted other than his own acceptances for value
E.
Contingent or other liabilities
F.
Creditors for rent, etc., recoverable by distress
G.
Preferential creditors for rates, taxes and wages
H.
Property
I.
Bills
J.
Debts due to the estate of exchange, promissory notes, etc., available as assets
Dated this day of M. 19.
(Signature)
Particulars of all property held by or in name of wife (or of any concubine.)
Nature of property.
When acquired.
From whom.
Consideration.
Remarks.
Dated this day of
439
19
(Signature)
[CAP. 6