FORM A

NOTICE OF SURRENDER OF A DEBTOR'S ESTATE (SECTION 4(1))

Notice is hereby given that application will be made to the

Division of the Supreme court on                                                                                

the __________ day of _______________________ 19 _____ at ________ o'clock in the forenoon or as soon thereafter as the matter can be heard, for the acceptance of the surrender of the estate of*                                                                                                                                                                                                  

of___________________________________________________________and that a statement of his affairs will lie for inspection at the office of the Master of the Supreme Court  at † ______________________(and at the office of  ______________________________(and at the office of ______________________) for period of fourteen days as from the ______ day of ___________________________19______

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Attorney for ______________________________

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_________________19__________