AiB 5 - Petitions - Page 11

APPENDIX D

Fax message to Accountant in Bankruptcy

Fax: 0300 200 2601

Information relating to a creditor's petition for sequestration

1. Debtor's details:

Name: _____________________________________________________________________

Address: ___________________________________________________________________

Phone: _____________________________________________________________________

2. Trading details:

Did the debtor trade? Yes/no

If yes, is he/she still trading? Yes/no

Nature of business: ___________________________________________________________________

Trading address: _____________________________________________________________________

___________________________________________________________________________________

If not still trading, date trading ceased: ___________________________________________________

3. Debtor's other details:

Solicitor: ____________________________________________________________________________

Accountants: _________________________________________________________________________

Bankers: ____________________________________________________________________________

4. Details of known assets:

Description Heritable Non-heritable

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

(Continue on separate sheet)

5. Any other information:

Contact name: _______________________________________________________________________

Sender's ref.: ________________________________________________________________________

Phone: _____________________________________________________________________________

Official use section

Case Ref. No.:

Faxed to CMB 0300 200 2601

Faxed to Agent - Fax:

Actioned by:__________________________________________________________________________

Date:________________________________________________________________________________