Affidavit verifying account

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..... ains a full and true account of my receipts and payments in the winding-up of the above-named company from the ..................... day of ................ 19 ........, to the ...................... day of ................ 19 ......., inclusive and that I have not nor has any other person by my order or for my use during such period, received or paid any moneys on account of the said company othe .....

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