Page:UKSRO 1890.pdf/63
Contingent or other liabilities as per list (E.)
£ " "
Of which it is expected will rank against the estate for dividend
Creditors for rent, &c. recoverable by distress as per
list (F.)
Creditors for rates, taxes, wages, &c., payable in full, as per list (G.)
Sheriff's charges payable under s. 11 of the Bankruptcy Act, 1890, estimated at - Deducted contra 9
Book debts as per list (I.), viz. :— Good Doubtful Bad £ Estimated to produce Bills of exchange or other similar securities, on hand as per list (J.) £ Estimated to produce Surplus from securities in the hands of creditors fully secured (per contra) £ Deduct creditors for distrainable rent, and for preferential rates, taxes, wages, sheriff's charges, &c. (per contra) Deficiency explained in statement (K.) £
I, of
in the county of,, make oath and say that the above statement and the several lists hereunto annexed marked A, B, C, D, E, F, G, H, I, J, and K, 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 in the county of this day of 189
Signature before me