B 58

[Subsidiary]

Please do not write in this binding margin.

CAP. 32]

Companies (Forms) Regulations

[1984 Ed.

LIST 'G'

Please complete legibly.

preferably in black type, or bold block lettering.

Statement of Affairs

In substitution for such of the lists 'A' to 'F' as would have to be returned blank

List Particulars Remarks

Where no entries are made on any one or more of the lists 'A' to 'F' the word 'Nil' should be inserted in this column opposite the list or lists thus left blank

A Assets not specifically pledged

B

C

D Assets specifically pledged and creditors fully or partly secured

(not including debenture holders secured by a floating charge)

Preferential creditors for rates.

taxes, salaries, wages and otherwise

Debenture holders secured by a floating charge .....

E Unsecured creditors

F Deficiency or surplus account

Signed

Date

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