1964_BANKRUPTCY_(FORMS)_RULES — Page 20

B 20

[Subsidiary]

↑ Strike out words which do not apply.

I,

CAP. 6]

Bankruptcy (Forms) Rules

[1977 Ed.

Gross liabilities Liabilities (as stated and estimated by debtor)

Of which it is expected will rank against the estate for dividend

Contingent or other liabilities as per list (E)... $ Expected to rank

Assets (as stated and estimated by debtor) Estimated to produce.

Bills of exchange, Or other similar securities on hand as per list (J) Estimated to produce.

Of which it is expected will rank against the estate for dividend

Surplus from securities in the hands of creditors fully secured] (per contra)

Creditors for rent, etc., recoverable by distress as per list (F)

Creditors for rates, taxes, wages, etc., payable in full as per list (G)

Deduct Creditors for distrainable rent and for preferential rates, taxes, wages, bailiff's charges, etc. (per contra)

Deducted contra ***********

† Deficiency explained in statement (K)

Surplus explained in statement (K)..

of

make oath and say that the above statement and the several lists hereunto annexed marked are, to the best of my knowledge and belief, a full, true and complete statement of my affairs on the date of the above-mentioned receiving order made against me.

Sworn at the Courts of Justice, Hong Kong, this day of ,19

Before me,

A Commissioner, etc.

(Signature)

$ Estimated to produce

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