PETITION BY DEBTOR TO DECLARED INSOLVENT





IN THE COURT OF District Judge _________________ Insolvency Petition No. _______. of 20_______



AA., aged. _______ years, son of. _______, resident of

______________

Debtor-Applicant;

Versus



1. BB., aged_______ years, son of _______, resident of _______

2. CC., aged _______ years, son of _______, resident of_______. etc.

Creditor—Opposite Party.

In the matter of the Insolvency of. . . . . . . .

The Provincial/Presidency

Towns Insolvency Act.

The abovenamed Debtor-Applicant begs to state under the provision of Section _______ of the _______ Insolvency Act as hereunder:

1. That the petitioner is unable to pay his debts.

2. That the ordinary residency of the petitioner is (or that the petitioner carries on business or personally works for gain at _______) _______ (or if he has been arrested). That the petitioner was arrested or imprisoned and is in custody at _______

3. That in execution of a decree standing against your petitioner, (Execution Case No. _______of _______ of the Court of. ______________), your petitioner was arrested and ordered to be sent to civil imprisonment (or that in execution of a decree standing against your petitioner) (Ex. Case No _______ of _______ of the Court of _______) your petitioner’s property has been attached.

4. That the total extent of the indebtedness of your petitioner is Rs._______ detail whereof, together with the names and residences of his creditors so far as they are known or can, by the exercise of reasonable care and diligence, be ascertained by him given in Schedule ‘A’ hereto.

5. The entire assets of your petitioner consist of a cash sum of Rs._______ and property the value of which and the place or places at which such property is to be found is given in Schedule ‘B’ hereto.

6. That your petitioner hereby declares his willingness to place at the disposal of this court all such property save insofar as it includes such property as is exempted by the Code of Civil Procedure, 1908, or by any other enactment for the time being in force from liability to attachment and sale in execution of a decree.

7. That the petitioner has not filed any application for adjudication as an insolvent in this or any other court. (If there has been any previous application give full particulars and result.)

The petitioner, therefore, prays for an order of adjudication as an insolvent.

Sd. AA.

Dated. _______

Petitioner.

VERIFICATION



I, AA., the petitioner named in the above application, do hereby at _______, verify that the contents of Paras _______ of the above application are true to my knowledge and that the contents of Paras _______ of the same application are believed by me to be correct.

Signed, dated and verified at._______ the _______ day of _______, 20 _______

SCHEDULE A:

Sd. AA.

SCHEDULE B:

Petitioner.