Companies. {Ch. 31. No. 1. 679

No. 88. (Rules 171 and 175.)
List of Amounts Paid or Payable to Contributories.
Name of Company.
P hereby certify that a return of surplus assets was declared payable to Contribu-
tories on and after the day of 19. at the rate of per
Share, and that the Contributories whose names are set forth below are entitled to

the \mounts set opposite their respective names, and have been paid such amounts
except in the cases specified as unclaimed.

Dated the dlay of

Registrar.

Amount returnec on Share.
Christian Ni

Paid. Unclaimed.

$ $

This List is required in duplicc