1984 Ed.]

LIST 'B' (consisting of

Statement of Affairs

Companies (Forms) Regulations

pages)

Assets specifically pledged and creditors fully or partly secured (not including debenture holders secured by a floating charge)

[CAP. 32

The names of the secured creditors are to be shown against the assets on which their claims are secured, numbered consecutively, and arranged in alphabetical order as far as possible.

B 67

[Subsidiary]

Please do not write in this binding margin.

Please complete legibly, preferably in black type, or bold block lettering.

Particulars

Date of assets when specifically pledged Date when security given Estimated value of security Date when contracted No. Name of creditor Address and occupation Amount of debt Consideration Month Year C $ S $ C $

Signed

Date.

Balance of debt unsecured carried to List E

Estimated surplus from security

S $

C $

S $

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