Free BOWLING GREEN MUNICIPAL COURT - Ohio


File Size: 90.0 kB
Pages: 2
Date: December 31, 2001
File Format: PDF
State: Ohio
Category: Court Forms - Local
Author: MARY COWELL
Word Count: 104 Words, 986 Characters
Page Size: Letter (8 1/2" x 11")
URL

http://www.bgcourt.org/forms/statement-as-to-creditors.pdf

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BOWLING GREEN MUNICIPAL COURT 711 S. Dunbridge Rd., P.O. Box 326 Bowling Green, OH 43402-0326 (419) 352-5263

In Re: __________________________________________ Debtor __________________________________________ Address __________________________________________ City/State/Zip Tel. Hm. _______________ Wk. _______________ Employer __________________________________ STATE OF OHIO, WOOD COUNTY, SS: The following is a full, accurate, and complete statement of the names of the unsecured creditors of the undersigned, their addresses, and amount due and owing to each: NAME 1. 2. 3. 4. 5. 6. ADDRESS ACCT # AMOUNT DUE No. ______________________________ STATEMENT AS TO CREDITORS Pay Period: ________________________

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On _____/_____/_____ sworn to before me and subscribed in my presence (seal)

_________________________________________ Debtor _________________________________________ Clerk of Court Deputy Clerk Notary Public, Com. Exp. ___/___/___ Judge