No.

Name of creditor.

Address and occupation.

No.

CAP. 32]

Companies.

LIST "B".

CREDITORS FULLY SECURED (NOT INCLUDING DEBENTURE HOLDERS).

Name of creditor.

Address and occupation.

Amount of debt.

$

Date when contracted.

Month. Year.

Consideration.

Signature Dated

LIST "C".

CREDITORS PARTLY SECURED.

(State whether also contributories of the company.)

Date when contracted.

Amount of debt.

Month. Year.

Consideration.

126

Signature Dated

Particulars of security.

Month and year when given.

19

Estimated value of security.

$

$

Particulars of security.

Date when given.

Balance of debt unsecured.

19

Estimated value of security.

Estimated surplus from security.

$

$

¢

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