CAP. 6]
Bankruptcy.
FORM 28.
[s. 18(1); rules 81, 150.]
* Sheet "L" should be substituted for any one or more of such of the sheets named as will have to be returned To the Debtor,
STATEMENT OF AFFAIRS.
(Title.)
You are required to fill up, carefully and accurately, this sheet and such of the several sheets A, B, C, D, E, F, G, H, I, J, K, L and M* as are applicable showing the state of your affairs on the day on which the receiving order was made against you, 19 day of
Such sheets, viz. the will constitute your Statement of Affairs, and must when filled up, be verified by oath, declaration or affirmation.
Gross liabilities.
Liabilities (as stated and estimated by debtor).
Expected to rank:
Assets (as stated and estimated by debtor).
Unsecured creditors as per list (A)
Creditors fully secured as per list (B)
Estimated value of securities
Surplus
Less amount thereof carried to sheet (C)
Balance thereof to contra
Creditors secured partly per as
Property as per list (H), viz.
(a) Cash at bankers
(b) Cash in hand
(c) Cash deposited with solicitor for costs of petition
(d) Stock-in-trade (cost $ >
(e) Machinery
(f) Trade fixtures, fittings, utensils, etc.
(g) Furniture
(h) Life policies
(i) Stocks and shares
(j) Reversionary or other interests under wills.
(k) Other property, viz.-
Total as per list (H).
list (C)
Less estimated value of securities
Liabilities on bills discounted other than debtor's own acceptances for value as per list (D), viz.-
On accommodation bills as drawer, acceptor or indorser
On other bills as drawer or indorser.
Book debts as per list (I), viz.-
Good
Doubtful
Bad
$ 432
Estimated to produce.
CAP. 6]
Bankruptcy.
FORM 28.
[s. 18(1); rules 81, 150.]
* Sheet "L" should be substituted
for any one or more of such of the sheets named as will have
to be
returned
To the Debtor,
STATEMENT OF AFFAIRS.
(Title.)
arefully
You are required to fill up, carefully and accurately, this sheet and such of the several sheets A, B, C, D, E, F, G, H, I, J, K, L and M* as are applicable showing the state of your affairs on the day on which the receiving order was made against you,
19 day of
Such sheets, viz. the
will constitute your Statement of Affairs, and must
when filled up,
be verified by oath, declaration or affirmation.
blank.
$
Gross
liabilities.
Liabilities
(as stated and estimated
by debtor).
Expected
to rank:
Assets
(as stated and estimated by debtor).
Unsecured creditors
as per list (A)
Creditors
fully
secured as per list (B)
Estimated value of
securities
Surplus
Less amount thereof
carried to sheet (C)
Balance thereof to
contra
Creditors
secured
partly per
as
Property as per list (H),
viz.
(a) Cash at bankers
(b) Cash in hand
(c) Cash deposited with solicitor for costs of petition
(d) Stock-in-trade (cost
$ >
(e) Machinery
(f) Trade fixtures, fit-
tings, utensils, etc. ...
(a) Furniture
(h) Life policies
(i) Stocks and shares
(j) Reversionary or other interests under wills.
(k) Other property, viz.-
Total as per list (H).
list (C)
Less estimated value
of securities
Liabilities on bills
discounted other than debtor's own acceptances for value as per list (D), viz.-
On accommodation bills as drawer, acceptor or in- dorser
On
other bills аз drawer or indorser.
Book debts as
Good
per list
(1), viz.-
Doubtful
Bad
$
432
Estimated
to produce.
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