Registrar's examination – corporation56 http://www.ucprforms.lawlink.nsw.gov.au/ucprforms/index.html

Form 56 (version 1)
UCPR 38.5

REGISTRAR'S EXAMINATION – CORPORATION

COURT DETAILS
Court
#Division
#List
Registry
Case number
TITLE OF PROCEEDINGS
[First] plaintiff	[name]
#Second plaintiff #Number of plaintiffs (if more than two)
[First] defendant	[name]
#Second defendant #Number of defendants (if more than two)
JUDGMENT DETAILS
Judgment creditor	[name] [role of party]
Judgment debtor	[name] [role of party]

[This form may be used when a registrar conducts an examination under UCPR 38.5(2). The form can be adapted as necessary to meet the requirements of the particular examination.]

Record of examination

INCOME
Estimated gross annual income of business		$
Nature of business

ASSETS
			CURRENT VALUE
Real estate	PROPERTY ADDRESS		$
	VALUE OF EQUITY, IF ANY	$
Funds in banks/ financial institutions, including funds held in off-set accounts	INSTITUTION, BRANCH, BSB AND ACCOUNT NUMBER		$
	INSTITUTION, BRANCH, BSB AND ACCOUNT NUMBER		$
Investments	NAME AND TYPE OF INVESTMENT		$
Motor vehicle	YEAR	MAKE	$
	MODEL	REGISTRATION NO

Sundry debtors	The company is owed money by the following people/ companies for the reasons shown:
	DEBTOR
	NATURE OF DEBT		$
	DEBTOR
	NATURE OF DEBT		$
	DEBTOR
	NATURE OF DEBT		$
Tools and equipment	DESCRIPTION AND LOCATION		$
TOTAL VALUE OF ASSETS			$

[Add extra lines, if necessary, so that all details of income and assets are disclosed.]

LIABILITIES
Average annual expenses:			Other liabilities:
ITEM	AMOUNT		LIABILITIES	NAME OF BANK/INSTITUTION	TOTAL AMOUNT OWED
Wages	$		Mortgage		$
Materials	$		Other loans		$
Mortgage/rent	$		Credit cards		$
Gas	$		Credit cards		$
Electricity	$		Other liabilities (specify)		$
Heating fuel	$
Rates/levies	$		TOTAL		$
Telephone	$
Motor vehicle
• Petrol	$
• Maintenance	$
• Registration/insurance	$
Other insurance (specify)	$
Superannuation	$
Workers compensation	$
Tax	$
Credit cards	$
Hire purchase payments	$
Other necessary commitments, including payments on other liabilities, listed above (specify)	$
TOTAL EXPENSES	$

[Add extra lines, if necessary, so that all details of expenses and liabilities are disclosed.]

ADDITIONAL QUESTIONS REGARDING FINANCIAL CIRCUMSTANCES

Does the company have any income, assets or liabilities not disclosed in this record of examination?

If you answered yes to the previous question, give details of the other income, assets (including their location) or liabilities.

What arrangements is the company prepared to make to pay this debt?

#Additional questions

DOCUMENTS PRODUCED AT EXAMINATION

The following documents were produced at the examination:

1. [ ]
2. [ ]

[on separate page]

AFFIDAVIT
Name
Address
Occupation
Date

I [#say on oath #affirm]:

1. I am [give details of the capacity of the person making the affidavit and the facts that qualify the person to make the affidavit].
2. I believe that the information contained in this record of examination about the judgment debtor's present income, assets and liabilities is true.

#SWORN #AFFIRMED at
Signature of deponent
Signature of witness
Name of witness
Address of witness
Capacity of witness	[#Justice of the peace #Solicitor #Barrister #Commissioner for affidavits #Notary public]

Note : The making of a false statement or the giving of false information in an affidavit is perjury and is an offence punishable by law under the Oaths Act 1900 (NSW).

SIGNATURE OF REGISTRAR

#[name] has verified the answers to the questions by affidavit and provided the documents listed above.

#[name] answered the questions under oath and provided the documents in the course of the examination.

The examination has been held and is concluded.

Date of examination
Held at
Signature
Date