AF00106663 Bankruptcy Solomons Tamworth - Flipbook - Page 50
St. 1676
Proof of Debt.
IN THE SUPREME COURT OF
NEW SOUTH WALES.
IN BANKRUPTCY.
No. 7e7
Ctacci'diWovt,t,
Be
-5i2(294z
Ex parte
State name of person
making the Proof.
ON
itvetA4
the
iezco/A-49(
I-6011 c
.Y etuA
of
Where a person
kroves as the Agent,
Attorney, or Clerk,
state the fact ; also
authority and means
of knowledge.
7
Name of Creditor.
Here state the cause
and particulars of
Debt, briefly, but
explicitly. (See
Forms and Directions
in Fold).
44A:cc,'
Bankrupt.
eA.-or4 ,,/
Creditor.
1890,
day of
Za,ttd-to-eo
being duly, sworn, states as follows :—
in the employ of the undermentioned
I am the
Creditor, and a duly authorized to make this Affidavit, and it is
within my own k owledge, that the debt hereinafter deposed to was
incurred, and forte consideration stated. My means of knowledge
are :—
The above-named Bankrupt at and before the Sequestration of
• justly and truly indebted to
Estate 'to ow and still
.,cam
efA
over and above all just allowances.
in the sum of Z
"
ors cC
For that /leo-
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et_
e„.
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(7.-e-e,-(fty
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of-.-0(
vit.td
F6(6.
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ct.6rA.-4 /Cu- ec,ou.te
etc
•
7 /
'aufte-fd--w?6
K.- -feta fwelAi
-etycef(" ciA.,,.c(
zaci
cr, Kai/Ley Gaut_
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u.,_c 4 et,s,
czettAA__
ttA.-00.,:
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c/tAf-- e,„ (44,
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 14 01 set-off against the said debt
. 6 , as far as I know and believe ; and I the said
of £
.0“. hold no security for the same ;
[Creditor] -5 r oie9 e g‘l(-4,t,c(4
.and ha lAc-- not received any payment in 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
year first above-mentioned, at
,7a4A.1-etra-et,
before me,
vdt tit_ecA
Ni-awart./
A Commissioner for Affidavits.)
N.B.—A Debt must be proved by delivering or sending through the post to the Registrar in Bankruptcy, Chancery
Square, Sydney, an Affidavit (with a copy thereof) verifying the debt, with fees 2s. and is. for each document exhibited. Fees
must be paid in cash or by P.O. Order. Stamps cannot be received for Court fees.
The Affidavit must contain or refer to a statement of account showing the full particulars of the debt, and giving dates,
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,
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.
