AF00106663 Bankruptcy Solomons Tamworth - Flipbook - Page 41
St. 167b
Proof _of Debt.
IN THE SUPREME COURT
NEW SOUTH WALES.
IN BANKRUPTCY.
011
No. 7a/
Be
Bankrupt.
Ex p rte
State name of pe
making the Pro
Creditor.
N the
1893,
of
Where a person
proves as the Agent,
Attorney, or Clerk,
state the fact ; also
uthori and means
kno ledge.
being duly sworn, states as follows :—
I am the
in the employ of the undermentioned
Creditor, and am duly authorized to make this Affidavit, and it is
within my own knowledge, that the debt hereinafter deposed to was
My means of knowledge
incurred, and ç the consideration state
re :—
a
fr
The above-named Bankrupt at and before the Sequestration of
Estate
and still
justly and truly indebted to
Name of Creditor.
in. the sum of £
Here s te he cause
and particu rs of
Debt, briefly, but
explicitly. (See
Forms and Directions
in Fold).
. /
, over and above all just allowances.
For that
°to
0-/-
(Y-Z
/6/27 -ct--'
ff-YL/
-iY
•
N
When the Bankrupt
has a Set-off, or a
Security is held,
state the nature,
dates, extent, and
value, as in Fold—
which see.
I further say the said Bankrupt has 71-4D1- set-off against the said debt
, as far as I know and believe ; and 4 the said.
of S:
[Creditor] eli..-7?()
no security for the same ;
and hat) not received any payment fin respect of the said demand, or
of any instrument securing the same, for which credit has not been
given in the abovementioned allowances.
Sworn by Deponent, on the day and
t above-mentio ed, at
Ye
before me,
da--44.0•4.
A Commissioner for Affidavits.)
post to the Registrar in Bankruptcy, Chancery
isentlingi through
lprhoved by the
is
„, A D
N,B.d--.
i for each document exhibited.
h fees
debt,
etesf 2s..and is.
reof) verifying
co
Fees
nebAtffimdia vtitb(ew t a copy
Square,
icour e es
y eiyn,caash or by P.O. Order. yStanripeso CavnenioltybnegreLeil(reed
must be paid
The Affidavit must contain or refer to a statement of account showing the full particulars of the debt, and giving dates,
Z, and shall specify the vouchers, if any, by which the same can be substantiated.
Interest at the rate of 6 per cent. only is allowed on promissory notes from date of maturity to date of sequestration,
14
and promissory notes must be produced.
Be particularly careful to fill up the affidavit in accordance with the printed directions on the back of this form.
The No. of the Estate must be stated on this form.
6e 70-93
