Affidavit in Proof of Debt
IN THE COURT OF . . . . . . . . . . . . . . . .
Cause name as in Forms No. 1 or 2.
In the matter of the Provincial Insolvency Act
And
The Insolvency of Shri . . . . . . . . . . . . . . . .
I, . . . . . . . . ., aged about . . . . . . . . ., years, resident of . . . . . . . ., make oath and say (or solemnly affirm and declare) as under:
1. That in the abovenoted case I am arrayed as Creditor No. . . . . . . ., in the array of opposite parties.
2. That the said . . . . . . . . ., petitioner abovenamed was at the date of the petition, viz., . . . . . . . . and still is justly and truly indebted to me in the sum of Rs. . . . . . . ., as shown by the account endorsed hereon (or the following account) viz., for which sum or any part thereof I say that I have not, nor hath received or been paid by any person by or the order of the said . . . . . . . . . . . . . . . ., to my knowledge or belief for my use, nor had or received any manner of satisfaction or security whatsoever, save and except the following:
Dated . . . . . . . the day of . . . . . . . . . . , 20 . . . . . . Deponent.
VERIFICATION