Form No. 067 - Proof of debt of workmen - Company Court Rules, 1959

Form No. 67 (See rule 152) [Heading as in Form No. 1] Company Petition No. ............. of 19 ....... Proof of debt of workmen I, ............... of, etc. (fill in full name, address and occupation of deponent), on behalf of the workmen and others employed by the above-named company, solemnly affirm and say: That the above-named company was, on the .............. day of .......... 19 ........., and still is justly and truly indebted to the several persons whose names, addresses and descriptions appear in the Schedule below in sums severaly set against their names in the seventh column of such Schedule for wages due to them respectively as workmen or others in the employ of the company, in respect of services rendered by them respectively to the company during such periods as are set out against their respective names in the fifth column of such Schedule, and for the accrued holiday remuneration so due to them in respect of such periods as are so set out in the sixth column of such Schedule, for which said sums or any part thereof, I say that they have not, nor has any of them, had or received any manner of satisfaction or security whatsoever. Deponent Schedule No. Full name of workmen Address Description Period over which wages due Period over which accrued holiday remuneration due Amount due 1 2 3 4 5 6 7 Rs. P. Solemnly affirmed, etc Deponent's Signature