IN THE (HIGH) COURT OF…………………………………………
In the matter of Companies Act, 1956
And
The matter of the liquidation of…………………… Company Limited.
I, A.B., aged………… years,
son of
Shri……………
resident of……………………, do hereby on oath
(or on solemn affirmation) state as follows:
1. That the abovenamed company was on the…………… day of………………, 2013, the date of the order for winding up the same, and still is justly and truly indebted to me in the sum of Rupees……………………… (Rs……………………) only in account of (describe briefly the nature of the debt).
2. That in proof of the aforesaid debt I attach hereto the documents marked A, B and C.
3. That I have not, nor have any person or persons by my order or to my knowledge or belief for my use, received the aforesaid sum of Rupees………………
or any part thereof, or any security or satisfaction for the same or any part thereof except the sum or security (state the exact amount of security).
4. That this my affidavit is true, that it conceals nothing and no part of it is false.
Sd/- A.B.
Dated
Verification
I, the abovenamed deponent, verify that the contents of paragraphs 1 to 4 of this affidavit are true to my personal knowledge.
Sd/-
A.B.
Dated…………………… I,……………………S/o…………………R/o…………………………declare, from a perusal of the papers produced by the deponent before me that I am satisfied that he is Shri A.B. Sd/-…………………… Solemnly affirmed before me on this…………………… day of…………………… 2013 of…………………… (time)
by the deponent.
Sd/-……………………
(Oath Commissioner)