Isi Notes On The Forms For Bankruptcy Page 24
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34Appendix 1 - Sample Affidavit based on ISI Bankruptcy Scenario 1
THE HIGH COURT
BANKRUPTCY
I, Gerry Scenario of 23 Church St. Dundrum, Dublin 14, IT Consultant as stated above on the
petition, aged 18 years and upwards, make oath and say as follows:
1. The petition contains a full and fair description of me as to my name, trade or profession and
last and usual place of abode.
2. I have, prior to presenting the petition, made reasonable efforts to reach an appropriate
arrangement with my creditors relating to my debts by making a proposal for a Personal
Insolvency Arrangement, to the extent that my circumstances would permit me to enter into such
an arrangement. Following advice from a Personal Insolvency Practitioner [insert name, address
and authorisation number of PIP], a proposal for a Personal Insolvency Arrangement was put to
my creditors at a meeting on [insert date]. However, the meeting rejected the proposal and
accordingly the Personal Insolvency Arrangement procedure came to an end. I was advised by the
Personal Insolvency Practitioner that it would not be appropriate for a person in my circumstances
Please attach a copy of the communication
to instead seek a Debt Settlement Arrangement because [state reason]. I beg to refer to [the
letter/email from the PIP/my note of the meeting/conversation confirming this advice] upon
record with the Personal Insolvency
which marked “A” I have signed my name prior to the swearing hereof.
Practitioner as Appendix A to this page and
3. The remaining allegations of fact in the said petition are true.
sign it.
SWORN by Gerry Scenario on 01/02/2014 at Dundrum Chambers
Gerry Scenario
Signed
before me a Commissioner for Oaths and the identity of the Deponent has
been established by me by reference to a relevant document containing a
photograph of the Deponent.
John Smith
____________________________________
Commissioner for Oaths
Dundrum Chambers, Dublin 14
23
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