1964_BANKRUPTCY_(FORMS)_RULES — Page 22

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B 22

[Subsidiary]

CAP. 6]

Bankruptcy (Forms) Rules

[1977 Ed.

No.

B

CREDITORS FULLY SECURED

Name Address
of and Amount credi-
tor occupa-
tion of debt

Date when contracted

Partic-
Con-
sidera-
tion

Date

Esti-
Esti-
mated mated
ulars value surplus

when
of secu-
of
from
rity given

SECU-
Secu-
rity rity

$ $ $

Dated this day of

C

CREDITORS PARTLY SECURED

(Signature) .19

Date

Esti-
Month

Name Address
when
Partic-
mated Balance

No.
tor of and Amount credi-
occupa-| of debt

tion contracted

Con-
sidera-
tion

and
ulars value
of debt
of secu

year
when
rity

SOCU-
un-
secured

Month Year
given

rity

$ $

No.

Dated this day of

D

(Signature) , 19

LIABILITIES OF DEBTOR on bills discounted other than his own acceptances for value

Wheth-
er

Amount

Acceptor's

liable Date

name, address and occupation

drawer
or en-
dorser
as

when
due Accom-
modation bills

Other bills

$

Dated this

Holder's
name, address and occupation (if known)

Amount expected to rank
against estate for dividend

day of

19

(Signature)

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B 22 [Subsidiary] CAP. 6] Bankruptcy (Forms) Rules [1977 Ed. No. B CREDITORS FULLY SECURED Name Addressof and Amount credi-tor occupa-tion of debt Date when contracted Partic-Con-sidera-tion Date Esti-Esti-mated matedulars value surplus whenof secu-offromrity given SECU-Secu-rity rity $ $ $ Dated this day of C CREDITORS PARTLY SECURED (Signature) .19 Date Esti-Month Name AddresswhenPartic-mated Balance No.tor of and Amount credi-occupa-| of debt tion contracted Con-sidera-tion andulars valueof debtof secu yearwhenrity SOCU-un-secured Month Yeargiven rity $ $ No. Dated this day of D (Signature) , 19 LIABILITIES OF DEBTOR on bills discounted other than his own acceptances for value Wheth-er Amount Acceptor's liable Date name, address and occupation draweror en-dorseras whendue Accom-modation bills Other bills $ Dated this Holder'sname, address and occupation (if known) Amount expected to rankagainst estate for dividend day of 19 (Signature)
Baseline (Original)
B 22 [Subsidiary] CAP. 6] Bankruptcy (Forms) Rules [1977 Ed. No. B CREDITORS FULLY SECURED Name Address of and Amount credi- occupa- of debt tor tion Date when contracted Partic- Con- sidera- tion Date Esti- Esti- mated mated ulars value surplus when of secu- of from rity given SECU- Secu- Month Year rity rity $ $ $ Dated this day of C CREDITORS PARTLY SECURED (Signature) .19 Date Esti- Month Name Address when Partic- mated Balance No. tor of and Amount credi- occupa-| of debt tion contracted Con- sidera- tion and ulars value of debt of secu year of when rity SOCU- un- secured Month Year given rity $ $ No. Dated this day of D (Signature) , 19 LIABILITIES OF DEBTOR on bills discounted other than his own acceptances for value Wheth- er Amount Acceptor's liable Date name, address and occupation drawer or en- dorser as when due Accom- modation bills Other bills $ Dated this Holder's name, address and occupation (if known) Amount expected to rank against estate for dividend day of 19 (Signature)
2026-05-04 06:55:50 · Baseline
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B 22

[Subsidiary]

CAP. 6]

Bankruptcy (Forms) Rules

[1977 Ed.

No.

B

CREDITORS FULLY SECURED

Name Address

of and Amount credi- occupa- of debt

tor

tion

Date when contracted

Partic-

Con- sidera- tion

Date

Esti- Esti- mated mated

ulars

value surplus

when

of secu-

of

from

rity

given

SECU-

Secu-

Month Year

rity

rity

$

$

$

Dated this

day of

C

CREDITORS PARTLY SECURED

(Signature)

.19

Date

Esti-

Month

Name Address

when

Partic-

mated

Balance

No.

tor

of and Amount credi- occupa-| of debt

tion

contracted

Con- sidera- tion

and

ulars

value

of debt

of secu

year

of

when

rity

SOCU-

un- secured

Month Year

given

rity

$

$

No.

Dated this

day of

D

(Signature)

, 19

LIABILITIES OF DEBTOR on bills discounted other than his own acceptances for value

Wheth-

er

Amount

Acceptor's

liable Date

name, address and occupation

drawer

or en- dorser

as

when

due Accom-

modation bills

Other bills

$

Dated this

Holder's

name, address and occupation (if known)

Amount expected to rank

against estate for dividend

day of

19

(Signature)

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