Bankruptcy.
RECEIPT.
19
Received of
and
respect of the
the sum of
dollars cents, being the amount payable to me/us in
dividend of
on my/our claim against this estate.
per cent
$
Sir,
(Creditor's signature)
AUTHORITY.
Please deliver (a) to me/us by post, at my/our risk or (a) to the bearer, Mr.
the cheque or money order for the dividend payable to me/us in this matter.
(Creditor's signature)
(Date)
, 19
To
FORM 142.
APPLICATION BY CREDITOR FOR ORDER FOR TRUSTEE TO PAY DIVIDEND WITHHELD AND ORDER THEREON.
(Title.)
[s. 73.]
I, F.K., of
make application to this court for an order to be made upon the trustee to pay the dividend in this bankruptcy due to me, with interest thereon for the time it has been withheld from me, that is to say, from the day of
on which day I applied to the trustee for its payment to me, and also to pay to me the costs of this application.
Dated this
day of
19
F.K.
ORDER.
19
Upon the reading of this application, and upon hearing it is ordered that the trustee do forthwith pay
to the said F.K. the sum of
dollars, the amount of
such dividend.
497
[CAP. 6
(a) Strike out words inapplicable. If not to be sent by post strike out words in italics, and insert the
name of the person who is to receive the cheque
or money order.