Isi Notes On The Forms For Bankruptcy Page 19

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Part 4 - Declaration
I, the said [insert your name] make oath and say:
The declaration must be sworn by you before a
Commissioner for Oaths or Practicing Solicitor.
I have carefully read the foregoing statement of my affairs, on each page of which I have signed
my name.
If you have any queries in regard to this form
you should contact:
* My debts exceed my assets by the sum of €
* My assets exceed my debts by the sum of €
Bankruptcy Division
I say that the same contains a full and true account of all debts due by me; that the same are justly
Insolvency Service of Ireland
due by me, save as therein otherwise stated; and that I am not, to my knowledge, indebted to any
person or persons except the creditors therein named.
Phoenix House
I say that the said statement contains a full and true account of all debts due to me and that there
Conyngham Road
are not to my knowledge or belief any debts due to me except the debts therein returned.
Dublin 8
I say that the said statement contains a full and true account and description of all other property
of any kind or description whatsoever of which I am possessed or to which I am entitled.
Phone: 076 106 4200
Email: bankruptcy@isi.gov.ie
SWORN by [insert your name] on [insert date] at
If you do not know the practising solicitor of
before me a Commissioner for Oaths/Practising Solicitor and
commissioner for oaths who is taking your
affidavit, you should bring photo ID to allow
You will be asked to swear the truth of your
I personally know the Deponent
your identify to be established. There is a fee of
affidavit and sign your name to the left of this
the Deponent has been identified to me by
who is personally known
block.
€10
to me and who certifies to me his/her personal knowledge of the Deponent
the identity of the Deponent has been established by me by reference to a
To be completed as appropriate by a
relevant document containing a photograph of the Deponent, namely,
Commissioner for Oaths or practising Solicitor.
____________________________________
Commissioner for Oaths/Practising Solicitor
Signed ___________________
Debtor
Note
It is the duty of the bankrupt to prepare his statement of affairs in this form and to be accurate in making
the statements for which the several columns are intended. Particular attention is required as to dates and
amounts.
* Insert as appropriate. Note that a debtor may not present a petition for adjudication unless the debts of
the debtor exceed the assets of the debtor by an amount greater than €20,000. (section 11(5), Bankruptcy
Act1988)
18

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