B 68
[Subsidiary]
CAP. 32]
Companies (Forms) Regulations
[1984 Ed.
Please do not write in this binding margin.
LIST 'C' (consisting of ... pages)
Statement of Affairs
Please complete legibly.
Preferential creditors for rates, taxes, salaries, wages and otherwise
The names to be arranged in alphabetical order and numbered consecutively
preferably in black type, or bold block lettering.
No. Name of creditor Address and occupation Nature of claim Period during which claim accrued due Date when due Amount of claimSigned
Date
Balance not payable in full Amount payable preferential $ C $ carried to List 'E'$ C
$ C