Debtor'S Bankruptcy Petition Form Page 3

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(iv) I have not been subject to an administration order under Part VI of the County
Courts Act 1984
OR
On (j)
an administration order was made against me in the
(l)
county court.
5. A statement of my affairs is filed with this petition.
Date___________________________________________
Signature_______________________________________
Complete only if
Endorsement
petition not heard
immediately
This petition having been presented to the court on _________________________ it is
ordered that the petition shall be heard as follows:-
Date ________________________________________________________________
Time ______________________________ hours
Place_______________________________________________________________

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