Form 41 Creditor's Petition

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No.

41
(General title)
[Follow Form No. 1]

CREDITOR'S PETITION (r. 98)

I, [insert name of petitioner and NRIC/company registration number] of [address] (or


we, ....................................... of............... and .................... of.......................................[this is applicable if it is a
joint petition]), hereby petition the court that a bankruptcy order may be made in respect of the
estate of (a) [insert name of debtor and NRIC] of (b) [description of debtor where appropriate, e.g
sole proprietor] and lately carrying on business at (or residing at) (c) [address] and say:

1. That the said debtor is domiciled in Malaysia or in any State or within one year before the
date of the presentation of the petition has ordinarily resided or had a dwelling house or place
of business in Malaysia or has carried on business in personally or by means of an agent or is or
has been within the same period a member of a firm or partnership which has carried on
business in Malaysia by means of a partner or partners or an agent or manager. (This is to fulfil
requirement of s.5(1)(d) IA)

2. That the said [insert name of debtor and NRIC] is justly and truly indebted to me (or us) in the
aggregate in the sum of (d) RM....................................... as at [date following BN] being the amount due
on a final judgment with interest and cost obtained by …………………… against you in [insert which
court in which the final judgment was obtained, suit number and date] and pursuant thereto a
Bankruptcy Notice filed on ………. for the amount due of RM…………
(the amount in this paragraph must be the same amount as stated in the BN)

3. That I (or we) do not, nor does any person on my (or our) behalf hold any security on the said
debtor's estate, or on any part thereof, for the payment of the said sum. [you are not a secured
creditor]
Or

That I hold security for the payment of (or part of) the said sum (but that I will give up such
security for the benefit of the creditors of .......................................in the event of his being adjudged
bankrupt) (or and I estimate the value of such security at the sum of RM.......................................).
[options for secured creditors in fulfilment of s.5(2) IA]
Or

That I,......................................., one of your petitioners, hold security for the payment of, etc.
That I,......................................., another of your petitioners, hold security for the payment of, etc.
[This to fulfil the requirement of s.5(2) IA on secured creditors – joint petition]

4. That [insert debtor’s name and NRIC] within six months before the date of the presentation of
this petition has committed the following (act or acts) of bankruptcy, namely (e) [nature and
date or date of the act or acts of bankruptcy relied on. If the act of bankruptcy is non-compliance
with a BN state the date of the BN and Request for Issue of BN and the manner it was served and
when][This is to show that the condition in s.5(1)(c) IA is fulfilled]
5. That the leave of court to commence a bankruptcy action against (f)........................................... (a
guarantor other than a social guarantor) had been granted on (g) ........................ [This is to
comply with s.5(3)(b) IA on guarantors other than social guarantors]

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


.......................................
Signed

Signed by the petitioner in my presence ........................


Signature of witness .......................................
Address ........................................
Description .....................

INDORSEMENT
[this will be filled up by the court/Registrar]

This petition having been presented to the court on the ....................................... day
of......................................, 20......................................., it is ordered that this petition shall be heard at
.................................. on the .......................................day of .......................................,20....................................,
at....................................... (time).
And you the said ................................. are to take notice that if you intend to dispute the truth of any
of the statements contained in the petition you must file with the Registrar of this court a notice
showing the grounds upon which you intend to dispute the same, and send by post a copy of the
notice to the petitioner (three) days before the date fixed for the hearing.

Dated this……..day of ……... 2021

…………………………
Registrar
[High Court…..]

This CREDITOR’S PETITION is filed by …….

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