Page:UKSRO 1890.pdf/362

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326
COMPANY.

No. 4.

List of Dividends or Composition.

I hereby certify that a dividend (or composition) of   in the £  has been paid, and that the creditors whose names are set forth below are entitled to the amounts set opposite their respective names.

Liquidator.
Dated the   day of   189 .

To the Board of Trade.

Surname. Christian Name. No. of
Shares 		Amount of Proof.
Paid. Unclaimed.
                 

No. 5.

List of Amounts paid or payable to Contributories.

I hereby certify that a return of surplus assets has been made to contributories at the rate of £ per share, and that the contributories whose names are set forth below are entitled to the amounts set opposite their respective names.


Liquidator.
Dated the day of 189.

To the Board of Trade.

Surname. Christian Name. No. of
Shares 		Amount returned on Shares.
Paid. Unclaimed.
                 
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