Companies.
To the Official Receiver.
Amount of dividend.
No. Surname. Christian name.
Town on which Post Office money order should be drawn.
Amount of proof.
Sums under $20 Sums of $20 and above $
FORM 69. (rule 142(5).)
CERTIFIED LIST OF PROOFS FILED UNDER RULE 142(5) COMPANIES (WINDING UP) RULES, SPECIAL BANK CASE.
(Title.)
I hereby certify that the following list has been compared with the proofs filed, and that the names of the creditors and the amounts for which the proofs are admitted are correctly stated.
Dated the (Signature) day of 19
I hereby certify that a dividend of per cent has been declared, and that the creditors whose names are set forth below are entitled to the amounts set opposite their respective names.
Dated this day of To the Official Receiver.
Surname. Liquidator. 19
Christian name. Amount of proof. Amount of dividend.
- $
163
[CAP. 32