Affidavit of Creditor proving debt
Company Petition No.
I, X.Y., of____________________________________________ etc., of solemnly affirm and say as
1. That the above-named company was on the_______________________________ ______________________________________ day of ________ and still is justly and truly indebted to me in the sum of Rs _________[here state the consideration for the debt, e.g., for goods sold and delivered by me to the company between__________________________________________________ and ________________________________ as shown by the account produced and shown to me and marked .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 thereof or any manner of satisfaction or security whatever for the same or any part thereof (except the security hereinbefore referred to).
Solemnly affirmed, etc. (Sd.) X.Y.
Note : Where the affidavit is made by an agent of the creditor, the deponent should state his authority for making the same and his means of knowledge.