Affidavit in Proof of Debt by Shiva.

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

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