Page:UKSRO 1890.pdf/66

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BANKRUPTCY, ENGLAND.
189

C.

Creditors Partly Secured.

No. Name of Creditor. Address and Occupation. Amount of Debt. Date when contracted. Consideration. Particulars of Security. Month and Year when Given Estimated Value of Security. Balance of Debt unsecnred.
Month. Year.
                                 

Signature

Dated

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