1984 Ed.]

Companies (Forms) Regulations

[CAP. 32

B 63

[Subsidiary]

NOTES

1.

2.

These figures must be read subject to the following notes: (a) [There is no unpaid capital liable to be called up].

[The nominal amount of unpaid capital liable to be called up is $ estimated to produce $________ which is is not charged in favour of debenture holders].*

(b) The estimates are subject to costs of the receivership and to any surplus or deficiency on trading pending realization of the assets.

The Commissioner is particularly requested, before swearing the Affidavit to ascertain that the full name, address and description of each Deponent are stated and to initial any crossings-out or other alterations in the printed form. A deficiency in the Affidavit in any of the above respects will entail its refusal, and will necessitate its being re-sworn.

Statement of Affairs List 'A'

Assets not specifically pledged

Name of bankers

*Delete as appropriate.

Please do not write in this binding margin.

Address

Full statement and nature of property Estimated book value $ Estimated to produce $ Balance at bank Cash in hand Marketable securities Please complete legibly, preferably in black type, or bold block lettering. Note: Full particulars of every description of property not specifically pledged and not included in any other list are to be set forth in this list. Bills receivable (as per schedule I) Trade debtors (as per schedule II) Loans and advances Unpaid calls (as per schedule III) Stock in trade† Work in progress† Freehold property Leasehold property Plant and machinery Furniture, fittings, utensils, etc. Patents, trade marks, etc. Investments other than marketable securities Other property

†State nature.

Signed

Date

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