Affidavit verifying account

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..... of the above-named company solemnly affirm and say: That the account hereunto annexed and marked 'A' contains 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 .....

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