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聲明參與分配狀(有執行名義之一般債權人)(Application for Participation in the Distribution)

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  • 最後更新日期:108-9-18
  • 資料點閱次數:599

明參與分配狀

Application for Participation in the Distribution

 

案號及股別:

Case No. and Section:

    人             住址:

                       身分證字號/營利事業統一編號:

                       電話:                 傳真:                     

Applicant               Address:

                        I.D. Card No./Uniform Business No.:

                        Telephone:              Fax:

 

法定代理人             住址:

                       身分證字號:

                       電話:                 傳真:

送達代收人             住址:

                       電話:

Legal Representative Address:

                         I.D. Card No.:

                         Telephone:              Fax:

Agent for Service        Address:

                         Telephone:

 

義 務 人               住址:

身分證字號/營利事業統一編號:

電話:                 傳真:

送達代收人              住址:

                        電話:

Obligor                  Address:

                          I.D. Card No./Uniform Business No.:

                          Telephone:              Fax:

Agent for Service        Address:

                          Telephone:

為聲明參與分配事:

To request the following matters relating to participation in the distribution:

聲明請准聲明人以新臺幣            元,並自民國            日起至           日止,按週年利率百分之   計算之利息,就貴分署     年度     字第          號義務人        之行政執行事件參與分配。

Please permit the applicant in this matter (Case No.[ ]; obligor [name]) to participate in the distribution of funds and be entitled to receive NT$[  ], calculated at an annual interest rate of [ ]%, commencing on [date] and ending on [date].

 

事實及理由

聲明人即債權人       與義務人               事件,業經       [_]法院    年度     字第      號判決確定在案。查義務人所有如附件所示之不動產,業經貴分署以      年度    字第      號行政執行事件查封並定期拍賣在案。為此檢附該判決書及判決確定證明書正本,請准予參與分配,以維權益。

Facts:

The matter between the applicant (i.e. creditor) and the obligor has been confirmed and finalized in a court judgment from [name of court] (court case no.[  ]).  The obligor’s immovable property as listed in the attachment has been sealed by the branch in case no. [  ] and has been put up for auction from time to time.  The original copy of the court judgment and the court’s final verdict have been attached hereto. Please grant the applicant the right to participate in the distribution of any funds resulting from the auction.

附件:

  1. 法院 年度     字第      號判決書正本。
  2. 法院 年度     字第      號判決確定證明書正本。
  3. 聲明參與分配之不動產清單。

Attachments:

  1. Original copy of [name of court]’s Judgment [Case No.]
  2. Original copy of Final Verdict of [name of court] in [Case No.]
  3. List of immovable property Involved in Participation in the Distribution:

 

  此致

法務部行政執行署臺南分署    公鑒

Respectfully submitted to Tainan Branch, Administrative Enforcement Agency, Ministry of Justice.

                                                

Date:

                    具狀人         (簽名蓋章)

[Signature/Seal of Applicant]

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