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Text File  |  1993-08-01  |  1KB  |  44 lines
  1.  
  2. LIST OF CREDITORS
  3.  
  4. _____________, conducts a business engaged in Retail Sales, at 
  5. ________________, ____________, __________. _____________ has 
  6. contracted to sell to _____________, in bulk, the following:
  7.  
  8. _____________________________________________________________
  9.  
  10. Pursuant to Art. 6-104 of the Uniform Commercial Code, 
  11. _____________ herewith lists all creditors of _____________.
  12.  
  13. Undisputed creditors:
  14.  
  15. See attached sheet
  16.  
  17. Disputed creditors (the following entities claim that they are 
  18. owed sums, however, _____________ disputes the same):
  19.  
  20. See attached sheet
  21.  
  22.  
  23. _____________________________________________ 
  24. For _______________
  25. As its: Owner
  26.  
  27. STATE OF ___________)))))
  28.  
  29. COUNTY OF __________)))))
  30.  
  31.  
  32. ______________________________________________________, appeared 
  33. before me, and swore or affirmed that the foregoing list of 
  34. creditors is true and correct to the best of their knowledge and 
  35. belief.
  36.  
  37.  
  38. Dated: ____________________________
  39.  
  40.  
  41. ___________________________________________________ 
  42. Notary Public
  43.                            
  44.