1977 Ed.]
Bankruptcy (Forms) Rules
FORM 28
STATEMENT OF AFFAIRS
(Title.)
[CAP. 6
B 19
[Subsidiary]
(s. 18(1); rules 81, 150.)
To the Debtor,
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, viz, the
19
day of
Such sheets, when filled up, will constitute your Statement of Affairs, and must be verified by oath, declaration or affirmation.
* Sheet "L" should be substituted for any one or more of such of the sheets named as will have to be returned blank.
Gross Liabilities (as stated and estimated by debtor)
Expected to produce
JUBI O
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 thereof
Less amount carried to sheet (C)
Balance thereof to contra
Creditors partly secured as per list (C)
Less estimated value of securities
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)
Liabilities on bills discounted other than debtor's OWN acceptances for value as per list (D), viz.-
On accommodation bills as drawer, acceptor or endorser
On other bills as drawer or endorser
Book debts as per list (I), viz.—
Good
Doubtful
Bad..
$
Estimated to produce
1977 Ed.]
Bankruptcy (Forms) Rules
FORM 28
STATEMENT OF AFFAIRS
(Title.)
[CAP. 6
B 19
[Subsidiary]
(s. 18(1); rules 81, 150.]
To the Debtor,
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, viz, the
19
day of
Such sheets, when filled up, will constitute your Statement of Affairs, and must be verified by oath, declaration or affirmation.
* Sheet "L" should be substituted for any one or more of such of the sheets named as will have to be returned
blank.
liabilities
Gross
Liabilities
(as stated and estimated
by debtor)
Expected
JUBI O
Assets
(as stated and estimated by debtor)
Unsecured creditors
as per list (A)
Creditors fully secured as
per list (B)
Estimated
securities
value of
Surplus
thereof
Less amount
carried to sheet (C)
Balance thereof to contra
Creditors partly secured as
per list (C)
Less estimated value of
securities
Property as per list (H), viz.
(a) Cash at bankers
(b) Cash in hand
(c) Cash deposited with so-
licitor for costs of petition}
(d) Stock-in-trade (cost $
(e) Machinery
(/) Trade
fixtures, fittings,
utensils, etc.
(g) Furniture
(k) Life policies
(1) Stocks and shares .................................*
(/) Reversionary or other in- terests under wills ..................................
(k) Other property, viz.-
Total as per list (H)
Liabilities on bills dis- counted other than
debtor's OWN accept- ances for value as per list (D), viz.-
On accommodation bills as drawer, acceptor or endorser
On other bills as drawer
or endorser
Book debts as per list (I), viz.—
Good
Doubtful
Bad..
$
Estimated
to produce
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