Form No. 6 R.

15 (3)

REPUBLIC OF KENYA

IN THE HIGH COURT OF KENYA

THE INSOLVENCY ACT

IN INSOLVENCY CAUSE NO……………………..OF 20……………….

RE:…………………………………………………………………………………….

t/a: ……………………………………………………………………………………..

B.O. /S. I. O. / L. O. made on ………………………….20………………OF………………………

STATUTORY DEMAND

To A.B. [or A.B.& Co.] .............................., of ............................

TAKE NOTICE that within [seven] days after service of this notice on you, excluding the day of such service, you must pay to C. D. ..................................
of ........................................ [or to ..................................................................... of ................................................... his [or their] agent duly authorized] (a) the sum of
Kshs. ..................claimed by (b) ................. as being the amount due on a Final Judgment or Order obtained by ( c) .......................................................... against you in the Court,
dated ......................................................., whereon execution has not been stayed, or you must secure or compound for the said sum to ( d) ................................................................
satisfaction [or the satisfaction of his [or their] said agent] (a) or to the satisfaction of the Court; or you must satisfy the Court that you have a counter-claim, set-off or cross-
demand against (c) .............................................................................. which equals or exceeds the sum claimed by ( c) ........................................ and which you could not set up in
the action or other proceedings in which the Judgment or Order was obtained.

FURTHER TAKE NOTICE THAT failure to pay the afore-stated amount shall result in C.D. filing for a bankruptcy order against your estate.

Dated this ........................ day of ...................................................................................................................., 20....................

By the Court,
Registrar.

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