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List of contributories as settled by Court

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..... the settlement of the list of contributories of the above company, made out and filed in Court by the Official Liquidator of the said company on the ............. day of ............. 19 ........, so far as the said list has been settled up to the date of this certificate, is as follows:-- The several persons whose names are set forth in the second column of the First Schedule hereto have been in .....

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..... th column of the second part of the First Schedule, and in the sixth column of the Second Schedule, are set forth, opposite the name of each of the several persons respectively, the date when such person was included in or excluded from the said list of contributories. 6. In the sixth and seventh columns of the first part, and the seventh and eighth columns of the second part, of the First Schedu .....

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..... called up at date of commencement of winding- Amount paid up at date of commencement of winding-up 1 2 3 4 5 6 7 8 The Second Schedule above referred to Serial Number Name & Description Address be included In what character proposed to of interest Number of shares or extent Date when excluded from the list 1 2 3 4 5 6 Dated the ............. day of ......... 19 ...... Distr .....

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