FORM 73B
rule 73.13(1)(a)
AFFIDAVIT AS TO STOCK
In the Supreme Court
of the Northern Territory
of Australia at [Darwin / ALICE SPRINGS]
No.
	In the matter of [identify the document comprising the stock under which the claimant's interest arises].
	I, [full name] of [address] make oath and say that according to the best of my knowledge, information and belief I have [or if the affidavit is made by the solicitor: [name of claimant] of [address] has] a beneficial interest in the stock specified in the notice filed with this affidavit as [describe the interest of the claimant in the stock and identify any document under which it arises].
	This affidavit is filed on behalf of [name of claimant] of [address].