(CAP. 32)
1984 Ed.]
Companies (Forms) Regulations
LIST 'D' (consisting of ... pages)
Statement of Affairs B 69 [Subsidiary]
Please do not write in this binding margin.
List of debenture holders secured by a floating charge
The names to be arranged in alphabetical order and numbered consecutively
No. Name of holder Address Amount Description of assets over which security extends
Please complete legibly, preferably in black type, or bold block lettering.
$
C
Signed Date