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Form 03

This document is an affidavit in proof of debt filed in an insolvency case. It states that [name redacted] is listed as Creditor No. [redacted] and that the petitioner owes [redacted] Rs. [redacted] as of [date redacted]. The deponent swears they have not received any payment or security for this debt except as noted. The document is signed and dated by the deponent.

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65 views

Form 03

This document is an affidavit in proof of debt filed in an insolvency case. It states that [name redacted] is listed as Creditor No. [redacted] and that the petitioner owes [redacted] Rs. [redacted] as of [date redacted]. The deponent swears they have not received any payment or security for this debt except as noted. The document is signed and dated by the deponent.

Uploaded by

Sathya Mandya
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as RTF, PDF, TXT or read online on Scribd
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No.

3
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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