Affidavit of creditor providing debt

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....o. 1] Company Petition No. ............... of 19 .......... A.B. & Co., Ltd.,-Petitioner. Affidavit of creditor providing debt I, X. Y., of ............... etc., do solemnly affirm and say....

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....d 'A', etc. State also the security held, if any, for the debt]. 2. I have not, nor has any person by my order to my knowledge or belief, for my use, had or received the sum aforesaid or any part t....