First Schedule
FORMS
[First Schedule amended by s. 8 of Act No. 122 of 1993.]
Wording of Sections
FORM A
NOTICE OF SURRENDER OF A DEBTOR’S ESTATE (SECTION 4 (1))
Notice is hereby given that application will be made to the
Division of the Supreme court on
the
day of
19
at
o’clock in the forenoon or as soon thereafter as the
matter can be heard, for the acceptance of the surrender of the estate of*
of
and that a statement of his affairs will lie for inspection at the office of the Master of the Supreme Court
at †
(and at the office of
) for
period of fourteen days as from the
day of
19..........
Attorney for
*Here insert the name in full of the debtor and his occupation and address, and if the
debtor is a partnership, its style or firm and the name in full and address of every partner,
other than a partner en commandite or a special partner as defined in the Cape Act No. 24 of
1861 or the Natal Law No. 1 of 1865.
†If the statement of the debtor’s affairs is to lie for inspection only in a Master’s office
delete the words in brackets.
FORM B
STATEMENT OF DEBTOR’S AFFAIRS (SECTIONS 4 (3) AND 16)
Balance sheet of....................................................................... *
Liabilities.
Debts due as per Annexure
IV
Assets
£ s. d
£ s. d
Immovable property as per Annexure I
Movable property, furniture, stock-in-trade etc.
as per Annexure II
Outstanding claims, etc., as per Annexure III
Deficiency
Total.
Total
* Here insert the name in full of the debtor
ANNEXURE I
IMMOVABLE PROPERTY
Description of
property
Situation and
extent
Mortgages
thereon
Estimated
values
£ s. d.
Property situate in the
Republic
Property situate
elsewhere
Total
ANNEXURE II
ANY MOVABLE PROPERTY WHATSOEVER WHICH IS NOT INCLUDED IN ANNEXURE III OR
ANNEXURE V
Description of
property
Estimated values
£ s. d.
Property situate in the Republic
Property situate elsewhere
Total
Note.—Any merchandise mentioned in the foregoing statement shall be valued at its cost
price or at its market value at the time of the making of the affidavit verifying this statement,
whichever is the lower, and the statement shall be supported by detailed stock sheets relating
to such merchandise.
ANNEXURE III
OUTSTANDING CLAIMS, BILLS, BONDS AND OTHER SECURITIES
Name and residential and
postal address of the
debtor
Particulars of
claim
Estimated
amount good
Estimated amount
bad or doubtful
£ s. d.
£ s. d.
In the Republic
Elsewhere
Total
ANNEXURE IV
LIST OF CREDITORS
Name and address of
creditor
Nature and value of security
for claim
Amount of Claim
£ s. d.
Nature of claim
Total
ANNEXURE V
MOVABLES ASSETS PLEDGED, HYPOTHECATED, SUBJECT TO A RIGHT OF RETENTION OR
UNDER ATTACHMENT IN EXECUTION OF A JUDGMENT
Description of
asset
Estimated value
of asset
Nature of
charge on
asset
Amount of debt to
which charge relates
Name of creditor in
whose favour charge
is
ANNEXURE VI
RENUMERATION AND DESCRIPTION OF EVERY BOOK IN USE BY THE DEBTOR AT TIME OF
NOTICE OF SURRENDER OR SEQUESTRATION, OR AT THE TIME WHEN HE CEASED CARRYING
ON BUSINESS
ANNEXURE VII
DETAILED STATEMENT OF CAUSES OF DEBTOR’S INSOLVENCY
ANNEXURE VIII
PERSONAL INFORMATION
State whether the debtor is married, widowed or divorced.
If the debtor is or was married, state—
(a)
name or names of spouse or spouses (a “spouse” means not only a wife or
husband in the legal sense, but also a wife or husband by virtue of a marriage
according to any law or custom, and also a woman living with a man as his wife
or a man living with a woman as her husband, although not married to one
another)
(b)
whether the debtor is or was married in or without community of property and
whether the accrual system applies
(c)
date of marriage
(d)
whether the matrimonial property system has been changed since entering into
the marriage and, if so, the nature of the change
(e)
full names and date of birth of the spouse and, if an identity number has been
assigned, the identity number of the spouse
State the debtor’s nationality
State the debtor’s place of birth, date of birth and, if an identity number has been assigned,
the identity number.
Was the debtor’s estate or the estate of a partnership in which the debtor is or was a partner
previously sequestrated or placed in bankruptcy, whether in the Republic or elsewhere?
If the preceding answer is in the affirmative, state—
(a)
whether the debtor’s own estate or
sequestrated; or (ii) placed in bankruptcy
his
partnership’s
estate
was
(i)
(b)
the place where and the date when that estate was sequestrated or placed in
bankruptcy
(c)
whether the debtor has been rehabilitated or his estate released; if so, when
The foregoing balance sheet and statements shall be verified by an affidavit in the subjoined
form, made by the debtor or by the person who on behalf of the debtor presented the petition
tendering the surrender of the debtor’s estate, or who is the representative of the debtor or
his estate.
AFFIDAVIT
I
declare
under oath/solemnly and sincerely declare* that to the best of my knowledge and belief the
statements contained in the foregoing balance sheet and the Annexures thereto are true and
complete, and that every estimated amount therein contained is fairly and correctly estimated.
Signature of declarant
Sworn*/Solemnly declared before me on the
day of
at
Commissioner of Oaths
* Delete inappropriate words.
FORM C
AFFIDAVIT FOR THE PROOF OF ANY CLAIM OTHER THAN A CLAIM BASED ON A PROMISSORY
NOTE OR OTHER BILL OF EXCHANGE (SECTION 44 (4))
In the Insolvent Estate of
Name in full of creditor
Address in full
Total amount of claim
£
I,
declare under oath/solemnly and sincerely declare*
(1)
That
, whose estate
was at the date of sequestration, and still is, indebted to
in the sum of
for
(2)
That the said debt arose in the manner and at the time set forth in the account
hereunto annexed.
(3)
That no other person besides the said
is liable (otherwise than as surety) for the said debt or any part thereof.
(4)
That I have/the said
has* not, nor has any
other person, to my knowledge on my*/his behalf received any security for
Signature of declarant
Sworn/Solemnly declared* before me on the
day of
at
Commissioner of Oaths.
*Strike out inappropriate words according to the facts of the case.
†Here insert nature, particulars and value of mortgage, pledge or other security.
FORM D
AFFIDAVIT FOR THE PROOF OF A CLAIM BASED ON A PROMISSORY NOTE OR OTHER BILL OF
EXCHANGE. (SECTION 44 (4))
In the Insolvent Estate of
Name in full of creditor
Address in full
Total amount of claim
I,
declare under oath/solemnly and sincerely declare*
(1)
That..............................., whose estate has been sequestrated, was on the date
of sequestration, and still is, indebted to ....................... in the sum
of......................................., by virtue of the following promissory note/bill of
exchange*.
Date of Name of maker
note or bill
or drawer
Name of
acceptor
Name of person to
whom payable
Date when
payable
Name of
endorser
Amount
(2)
That the said debt arose in the manner and at the time set forth in the account
hereunto annexed.
(3)
That I have/the said
has* not, nor has any other person to my
knowledge on my/his* behalf received any security for the said debt or any part
thereof, save and except†
(4)
That besides the said......................................one
mentioned above, is liable to me/the said
*
of the said note/bill,* as aforesaid.
(5)
That the said note/bill* is in all respects genuine and valid.
Signature of declarant
Sworn/Solemnly declared* before me on the
day of
at
Commissioner of Oaths
*Strike out inappropriate words, according to the facts of the case.
†Here insert nature, particulars and value of mortgage, pledge or other security.
Wording of Sections
sch 1 of Act 24 of 1936 prior to amendment by Act 122 of 1993