Form 19	Consent to act as designated person
Court Procedures Rules 2006
(see sch 6 r 15A.5 (Official liquidator's consent to act))

In the Supreme Court of the Australian Capital Territory

No SC		of (year)
In the matter of (full name of corporation to which the proceeding relates and, if applicable, the words ‘(in liquidation)’, ‘(receiver appointed)’, ‘(receiver and manager appointed)’, ‘(controller acting)’ or ‘(under administration)’)
*[ABN/ACN/ARBN]:

(name) *[and others]
Plaintiff

(list, in a schedule, any further plaintiffs)
(name) *[and others]
*Defendant

(list, in a schedule, any further defendants)

I, (name), of (address), an official liquidator, consent to be appointed by the Court and to act as the person designated by the Court under the Model Law, *[article 19/article 21] to *[administer/realise/distribute] the assets of (name of company).
I am not aware of any conflict of interest or duty that would make it improper for me to act as the person designated by the Court.

The hourly rates currently charged in relation to work done as the person designated by the Court by me, and by my partners and employees who may perform work in this administration, are set out below or in the schedule attached to this consent.

I acknowledge that my appointment by the Court does not constitute an express or implied approval by the Court of these hourly rates.

Date:

Signature of official liquidator

*omit if, or whichever is, inapplicable
Schedule
(description of hourly rate(s))