No.
Companies.
RECEIPT.
19
Received of the
[Official Receiver and] Liquidator
the sum of dollars
and cents
being the amount payable to me/us in respect of the
per share held by me/us
in this company.
Contributory's signature
SIR,
AUTHORITY FOR DELIVERY.
PLEASE deliver to
(Insert the name of the person who is to receive the cheque or money order, or the words "me/us by post," at "my/our risk", if you wish it sent to you in that way.)
the cheque or money order for the return payable to me/us in this matter.
Contributory's signature
To the [Official Receiver and] Liquidator.
FORM 74. (rule 143).
SCHEDULE OR LIST OF CONTRIBUTORIES HOLDING PAID-UP SHARES TO WHOM A RETURN IS TO BE PAID (a).
In the matter of
No.
of 19
(a) Where the articles provide that the amount divisible among the members or any class of the members shall be divisible in proportion to the amount paid up or which ought to have been paid up at the date of winding up, or contain any other provision which will necessitate further information before a return can be made, columns should be added showing the amount called up and the amount paid up at such date in respect of shares then held by such members or class of members or such other facts as may be requisite.
167
[CAP. 32