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SCHEDULE 2— continued Registered no.: COMPANIES FORM 107 Sub-section 454 (4) NOTICE. OF DISCLAIMER OF ONEROUS PROPERTY To......................................................................................................................................................... For the purposes of sub-section 454 (1), \*and by leave of the Supreme Court of................................. ..............................granted on the ...................................................................day of.............................. 19.........I,.............................................................................................................................the liquidator of the company, disclaim the following property, being property that is \*land burdened with onerous covenants/\*shares in corporations/\*unsaleable or not readily saleable/\*an unprofitable contract. \*As required by sub-section 454 (6), notice of intention to disclaim the lease referred to in the Schedule was given to (set out the name of each person to whom notice was given and the date on which the notice was given to that person) and no person to whom notice was so given has required me to apply to the Supreme Court of...................................................................................................for leave to disclaim the lease. Signature of liquidator................................................................ Registered no.: COMPANIES FORM 108 Paragraph 454 (6) (a) Companies Act 1981 Regulation. 69 NOTICE: OF INTENTION TO DISCLAIM LEASE To.........................................................................................................................................,.................... I,........................................................................................the liquidator of the company give you notice of my intention to disclaim the lease (set out such particulars of the lease us will identify the lease and the property the subject of the lease). You may, within 28 days after this notice is given to you, serve on me a notice requiring me to apply to the Supreme Court of................................................................................for leave to disclaim the lease. Unless you serve such a notice on me within that period, the lease may be disclaimed without the leave of the Court and without further notice to you. Dated this................................day of................................. 19......... Signature of liquidator................................................................ Address......................................................................................... Registered no.: COMPANIES FORM 109 Paragraph 454 (8) (a) APPLICATION REQUIRING LIQUIDATOR TO DECIDE WHETHER TO DISCLAIM PROPERTY To.............................................................................................the liquidator of the company. Pursuant to paragraph 454 (8) (a), application is made to you by (full name, address and occupation of applicant) requiring you to decide whether you will disclaim the property described in the Schedule to this notice or not. The applicant has the following interest in the property: Signature of applicant.............................................................. Registered no.: COMPANIES FORM 110 Sub-sections 501 (1) and (2). 502 (1) and (2) NOTICE: BY \*RECOGNIZED COMPANY/\*RECOGNIZED FOREIGN COMPANY OF PRINCIPAL OFFICE AND OF OFFICE. HOURS IN PARTICIPATING STATE OR PARTICIPATING TERRITORY Notice is given that \* as from the........................................day of............................................19......................................the situation of the principal office of the \*recognized company/\*recognized foreign company in (1) ........................................is (2) ................................................................................................................. \* as from the........................................day of...........................................19.......................................the situation of the principal office of the \*recognized company/\*recognized foreign company in (1) .............................................has been changed to (2)................................................................................ \* the hours during which the principal office of the \*recognized company/\*recognized foreign company in (1) .................................................is open and accessible to the public in accordance with sub-section 501 (2) are............................................................................................................................. \* as from the........................................day of..........................................19........................................the hours during which the principal office of the \*recognized company/\*recognized foreign company in (1) ............................................. is open and accessible to the public in accordance with sub-section 502 (2) have been changed to............................................................................................................... Dated this........................................day of.............................................19.......... Signature of \*Director/\*Secretary/\*Principal Executive Officer/\*of/\*Agent(3)................................. (1) insert name of participating State or participating Territory. (2) in accordance with section 530a, specify the full address, or the full new address, as the case requires, of the relevant office including, where applicable, the number of the room and of the floor or level of the building on which the office is situated. (3) Where the agent is a natural person, insert name accordingly. Where the agent is a company, the form must be signed by a director or secretary or the principal executive officer of that company. In accordance with section 530a, where a company is not to occupy premises the address of which is specified in the notice as the address of its principal office, the consent of the occupier of the premises, in accordance with Form 150, must be annexed to this notice. Registered no.: COMPANIES FORM 111 Sub-section 501 (3) CERTIFICATE AS TO ADDRESS OF PRINCIPAL OF OFFICE IN PARTICIPATING STATE OR PARTICIPATING TERRITORY This is to certify that....................................................................................................................Limited has a principal office in (1)...................................................................................................................... and the address is..................................................................................................................................... Given under the seal of the National Companies and Securities Commission at.................................... on this........................................day of........................................19........ Registered no. : COMPANIES FORM 112 Section 503, sub-section 518 (1) NOTICE OF CESSATION OF BUSINESS .............................................................................................................Limited gives notice that as from the .........................day of................................ 19........ it \*has ceased to carry on business/\*has ceased to have a place of business in (1).............................................................................................................. Dated this................................day of................................19............. Signature (2)............................................................... \* Strike out whichever is inapplicable. (1) Insert name of State or Territory. (2) The form must be signed by a director or secretary, or the principal executive officer, or an agent, of the corporation. Where the agent is a company, the form must be signed by a director or secretary or the principal executive officer of (hat company. Registered no.: COMPANIES FORM 113 Paragraphs 512 (2) (c) and 515 (2) (b) RETURN BY FOREIGN COMPANY GIVING PARTICULARS OF DIRECTORS OR MEMBERS OF OTHER GOVERNING BODY AND CHANGES OF PARTICULARS | Present names.(1) (State any former names in brackets beneath present names) | Address(2) | Business occupation (if any) | Particulars of other directorships (3) | Particulars and nature of appointment or change, and relevant date(4) | | ---------------------------------------------------------------------------- | ---------- | ---------------------------- | -------------------------------------- | --------------------------------------------------------------------- | | | | | | | Dated this................................day of................................19.......... Signature................................................................ \------------------------------------------------------------------------------------------------------------------------- (1) Insert, in the case of an individual, his present Christian or given name and surname and any former Christian or given name and surname, or. in the case of a corporation, its corporate name. (2) Insert, in the case of an individual, his usual residential address, or. in the case of a corporate director, the address of its registered or principal office. (3) Insert particulars of directorships held by the director in corporations that under the law of a State or Territory are public companies or subsidiaries of public companies but not particulars of directorships held by the director in a corporation that is deemed to be related to the company. Where a person is a director in one or more subsidiaries of the same holding company, it is sufficient to disclose that the person is the holder of one or more directorships in that group of companies and the group may be described by the name of the holding company with the addition of the word "Group". If no other directorships, state accordingly. (4) Insert in relation to a new director "Appointed" or "In place of (former director's name)". Insert in relation to a former director "Died", "Resigned", "Removed", or as the case may be. Where there is no change, insert "Continuing". 1\. A return notifying the Commission of a person having ceased to be or having become a director must contain, with respect to each person who is, at the lime of the lodgment of the return, a director of the corporation, the particulars required to be specified in the register. 2\. Where the agent is a corporation, the form must be signed by a director or secretary or the principal executive officer of that corporation. Registered no.: COMPANIES FORM 114 Paragraphs 512 (2) (fa) and (g), sub-sections 513 (2), 515 (I) and (3), paragraph 515 (2) (d) NOTICE IN RELATION TO REGISTERED OFFICE OR PRINCIPAL PLACE OF BUSINESS \* .............................................................................................Limited, a foreign company seeking registration, gives notice \* in pursuance of sub-section 512 (2), that the address of its \*registered office/\*principal place of business in its place of incorporation or formation is........................................................... \* in pursuance of sub-section 512 (2), that the address of its registered office in(1).............................. is............................................................................................................................................................... \* ....................................................................................................Limited, a registered foreign company, gives notice \* in pursuance of sub-section 515 (1), that the situation of its registered office in(2)............................. has been changed or altered to.................................................................................. \* in pursuance of sub-section 515 (2), that the situation of its \*registered office/\*principal place of business in its place of incorporation or formation was changed or altered to...................................... ..................................................as at........................................19........ \* that the hours during which the registered office of the registered foreign company will be open and accessible to the public in accordance with paragraph 513 (1) (a) are........................................... \* that, as from the....................................day of...................................... 19.......the hours during which the registered office of the registered foreign company is open and accessible to the public in accordance with paragraph 513 (1) (a) have been changed to............................................................... Dated this.............................day of..............................19...... Signature of \*Director/\*Secretary/\*Principal Executive Officer/\*of/\*Agent (3)................................... (1) Insert name of State or Territory in which the foreign company is seeking registration. (2) Insert name of State or Territory in which the foreign company is registered. (3) Where the agent is a company, the form must be signed by a director or secretary or the principal executive officer of that company. –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– 1\. In accordance with section 530a, specify the full address, or the lull now address, as the case requires, of the relevant office including, where applicable, the number of the room and of the floor or level of the building on which the office is situated. 2\. In accordance with section 530a, where a corporation is not to occupy premises the address of which is specified in the notice as the address of its office, the consent of the occupier of the premises, in accordance with Form 150 must accompany that notice. Registered no.: COMPANIES FORM 115 Paragraph 512 (2) (h) STATEMENT IN WRITING BY AGENT OF FOREIGN COMPANY I,...........................................................................................of............................................................ state I,...............................................................Limited, a foreign company, intends to \*carry on business/ \*establish a place of business in.....................................................................................; 2\. \* I am the duly appointed agent of the company in (1)................................................................... pursuant to a \* memorandum of appointment/\*power of attorney dated the................................. day of........................................19........: \* I am the \*director/\*secretary/\*principal executive officer of....................................Limited the address of the registered office of which is........................................................................), which is a duly appointed agent of the company in (1).............................................................................. pursuant to a \* memorandum of appointment/\*power of attorney dated the...........................day of........................................19........; 3\. the foreign company was formed or incorporated in (2).................................................................. (1) Insert name of State or Territory for which agent has been appointed. (2) Insert place of incorporation or formation. Registered no.: COMPANIES FORM 116 Sub-section 514 (3) NOTICE BY FOREIGN COMPANY OF CESSATION OF AGENCY ....................................................................Limited gives notice that \* on the....................................day of.................................19............................................................. of.........................................................................................ceased to be its agent in........................ \* on the....................................day of....................................19.......................................................... of....................................................................................will cease to be its agent in....................... Dated this....................................day of....................................19........ Signature of \*Director/\*Secretary/\* Principal Executive Officer............................................................ \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ Registered no.: COMPANIES FORM 117 Sub-section 514 (3) NOTICE BY AGENT OF FOREIGN COMPANY OF CESSATION OF AGENCY ..............................................................................Limited (1) I...........................................................................of.................................................................................. give notice that \* on the................................................day of....................................19.........I \*ceased/\*will cease to be the agent of the foreign company in................................................. \* on the....................day of....................................19.........(2)................................. ……….......................................Limited \*ceased/\*will cease to be the agent of the foreign company in........ Dated this................................day of................................ 19......... Signature of \*Director/\*Secretary/\*Principal Executive Officer/\*of/\* Agent........................................ (1) Where the agent is a natural person, insert name accordingly. Where the agent is a company, the form must be signed by a director or secretary or the principal executive officer of that company. (2) Insert name of company where a company is the agent. Registered no.: COMPANIES FORM 118 Sub-section 514 (6) CERTIFICATE OF REGISTRATION OF FOREIGN COMPANY This is to certify that (1)...................................................................................Limited, which was formed or incorporated in (2).......................................................................was, on the.......................... day of........................................19.........duly registered under the (3)..................................................of (4)................................................... \* The name of (1)..............................................................................................Limited was changed on the ........................................day of........................................19........from (5)......................................... Given under the seal of the National Companies and Securities Commission at ................................... on this........................................day of........................................19........ (1) Insert present name of registered foreign company. (2) Insert place of incorporation or formation. (3) Cite the law relating to companies under which the foreign company is registered. (4) Insert the name of the State or Territory in which the foreign company is registered. (5) If the certificate is issued on a change in the name of the corporal ion, insert the previous name. Registered no.: COMPANIES FORM 119 Paragraphs 515 (2) (ii), (e)and(f) PARTICULARS OF CHANGE OR ALTERATION RELATING TO FOREIGN COMPANY .....................................................................................................Limited, a foreign company registered in (1)...............................................................................gives notice that, on the...............................day of ................................... 19.......a change or alteration was made in \* the charter, statute, memorandum or articles of the company or other instrument constituting or defining its constitution. \* the name of the company. \* the powers of any directors resident in (1)...........................................................who are members of the local board of directors or members of the governing body or the local governing body of the company. Particulars of the change or alteration are as follows: The following documents are lodged with this form: (list any documents required by regulations 76 to 78) Dated this....................................day of.................................... 19...... Signature of \*resident director/\*agent(2).................................................. (1) Insert name of State or Territory in which registered. (2) Where the agent is a company, the form must be signed by a director or secretary or the principal executive officer of that company. –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– 1. Where there is insufficient space on this form to furnish the required information, the information is to be shown in a separate annexure. 2. Requirements relating to annexures are set out in regulation 8. Registered no.: COMPANIES FORM 120 Paragraph 515 (2) (c) PARTICULARS OF CHANGE. OR ALTERATION RELATING TO AGENT OF FOREIGN COMPANY .........................................................................................Limited, a foreign company, gives notice that \* on the....................................day of....................................19........................................................ ceased lobe the agent of the company in (1)............................................................. \* on the....................................day of....................................19.......................................................... ......................................................of........................................................................became the agent of the company in (1)......................................................... \* on the........................................day of.......................................... 19......the address of the agent of the company in (1)..................................................was changed to.............................................. \* on the .................................... day of .................................... 19 ......, the name of the agent was changed from................................................to ................................................................................ Dated this....................................day of................................ 19...... Signature of \*resident director/\*agent(2).................................................. (2) Where the agent is a company, the form must be signed by a director or secretary or the principal executive officer of that company. Registered no.: COMPANIES FORM 121 Sub-section 516 (1) STATEMENT IN WRITING VERIFYING BALANCE-SHEET, PROFIT AND LOSS ACCOUNT, &c., OF FOREIGN COMPANY (1)..................................................................................Limited I......................................................................of................................................................................state 1\. \*I am(2)......................................................................of (1).................................................................... .........................................Limited. \* I am the secretary of....................................................................................Limited (the address of the registered office of which is ......................................................................................), which is the duly appointed agent of (')..............................................................................Limited in (3)......................... 2\. I verify that the copies annexed to this statement are true copies of the documents required to be lodged under sub-section 516 (1) in relation to (1)..........................................................Limited, being (a) its balance-sheet made up to the end of the last financial year, being the period that ended on the..................day of......................................19......; (b) its profit and loss account for the last financial year; and \*(c) the documents that it is required to prepare by the law for the time being applicable to it in the place of its incorporation or formation, being (4).................................................................................... Signature.................................................................... (1) Insert name of foreign company. (2) Insert "the duly appointed agent", "a director" or "the secretary". (3) Insert name of State or Territory. (4) Insert a short description of the documents. –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– 1. Where there is insufficient space on this form to furnish the required information, the information is to be shown in a separate annexure. 2. Requirements relating to annexures are set out in regulation 8. Registered no.: COMPANIES FORM 122 Sub-section 516 (8) ANNUAL RETURN OF FOREIGN COMPANY Annual return of.........................................................................................Limited, a foreign company, made up to the...................................day of..............................................................................19......, being the date of the annual general meeting in 19...... 1. The address of the registered office in (1)..........................................................is.............................. 2. The address of the registered office (or if there is no registered office the principal place of business) in the place of incorporation or origin is ........................................................................... 3. The amount of the authorized share capital of the company is........................................................... 4. The amount of paid up capital of the company is .............................................................................. 5. Particulars of the directors of the company are as follows: (2) The present Christian or given name or names and surname (3) Usual residential address ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ 6. The name of the agent in (1)........................................is (2).............................................................. 7. The residential address of the agent in (1).......................................is (3)............................................ I certify that the company is, by virtue of the provisions of sub-section 516 (7), exempt from the provisions of sub-section 516 (1) requiring the company to lodge each calendar year copies of its balance-sheet, profit and loss account and other required documents made up to the end of its last financial year. Dated this..................................day of..................................19...... ………………………………………………………………………………………………………...... (4) Signature of \*Director/\*Secretary/\*Principal Executive Officer/\*of/\*Agent CERTIFICATE RELATING TO UNCLAIMED MONEYS I, after having made due enquiries, certify that the provisions of the law relating to unclaimed moneys have been complied with in relation to the company. Dated this..................................day of..................................19...... Signature of Agent (5)............................................................... (2) In the case of a corporation, the corporate name is to be shown. (3) In the case of a corporation, the address of the registered office is to be shown. (4) This certificate is to be signed by a director or secretary or the principal executive officer. Where the agent is a company, the form must be signed by a director or secretary or the principal executive officer of that company. (5) This certificate is to be signed by the agent. Registered no.: COMPANIES FORM 123 Paragraph 518 (11) (a) NOTICE BY AGENT OF FOREIGN COMPANY OF LIQUIDATION OR DISSOLUTION OF COMPANY (1) I,.....................................................................of...................................................................................... give notice that on the.....................................................day of........................................19........,.......... .........................................................................Limited a foreign company registered in (2)......................... \* went into liquidation in (3)..............................\* and........................of.................... .............................................was appointed liquidator. \* was dissolved in (3).............................................................................. \* I............................................/\*............................................Limited was the agent of the company in (2).............................................................immediately before the commencement of the liquidation proceedings. Signature of Agent (1)................................................................. (1) Where the agent is a natural person, insert name accordingly. Where the agent is a company, the form must be completed and signed by a director or secretary or the principal executive officer of that company. (3) Insert the name of the place of incorporation or formation of the company. Registered no.: COMPANIES FORM 124 Sub-section 518 (12) NOTICE BY FOREIGN COMPANY OF PLACING UNDER OR TERMINATION OF OFFICIAL MANAGEMENT IN PLACE OF INCORPORATION ........................................................................Limited, a foreign company registered in (1).................. .....................................................gives notice that, on the................................day of............................. 19....... \* the company was placed under official management in (2) ............................................................. under (3).....................................................................................a law or enactment corresponding to Part XI, and..................................................................of.............................................................. was appointed official manager. \* the period of official management of the company in (2)................................................................. was terminated on the................................day of................................19......,by (4) ........................ Dated this................................day of................................19...... Signature(5).......................................................... \* Strike out whichever is inapplicable. (1) Insert name of State or Territory. (2) Insert name of place of incorporation or formation. (3) Cite law of State or Territory. (4) Set out method of termination. (5) The form may be signed by the agent, the secretary or principal executive officer, or a director (or person who immediately prior to the company's being placed under official management was a director). The person signing must indicate in what capacity he signs. Where the agent is a company, the form must be signed by a director or secretary or the principal executive officer of that company. Registered no.: COMPANIES FORM 125 Paragraph 577 (1) (d) Sub-regulation 84 (2) NOTICE OF MEETING 1\. Notice is given that a \*meeting of the \*creditors/\*members/\*contributories/\*holders of debentures/ \*joint meeting of creditors and members of the company/\*a meeting of the company and its creditors will be held at....................................................................on the....................................day of ........................................19........, at.....................\*a.m./\*p.m. (1) Agenda: \*(2) 2. The statement and report prepared in accordance with paragraph 342 (1) (a) are available for inspection at (3).......................................................................between the hours of (4).................. and..................... Dated this.........................................day of......................................19........ (1) Set out the purpose for which the meeting is called. If the notice relates to a meeting of creditors called under sub-section 398 (1), the notice is to state that a person is not entitled to vote as a creditor at the meeting unless he has lodged with the chairman of the meeting particulars of the debt or claim which he claims to be due to him from the company. (2) To be used when the meeting is called under sub-section 342 (1). (3) Insert the full address of the registered office of the company. (4) State the hours between which the registered office of the company is open and accessible to the public. Registered no.: COMPANIES FORM 126 Paragraph 577 (1) (d) Regulation 85 STATEMENT IN WRITING OF POSTING OF NOTICES OF MEETING I,.........................................................of...............................................................state 1\. on the.......................................day of..........................................................19................................a notice of the time and place of the (1) ....................................... in the form of the annexure marked ..................................... (2) was sent by prepaid post to each person appearing in the books of the company, or otherwise known to \*me/\*the convener of the meeting, as a \*creditor/\*contributory/\*member/\*debenture holder; \*2. the notices were addressed to the creditors according to their respective names and addresses appearing in the books of the company or to their last known addresses; \*2. the notices were addressed to the contributors according to their respective names and addresses appearing in the books of the company or to their last known addresses; \*2. the notices were addressed to the debenture holders according to their respective names and addresses appearing in the books of the company or to their last known addresses; (2) 3. the persons notified and their respective addresses specified in the notices sent to them are \*set out in the annexed list/\*identifiable by reference to the books of the company. (1) Insert a description of the meeting. Registered no.: COMPANIES FORM 127 Paragraph 577 (1) (d) Sub-regulation 99 (2) LIST OF PERSONS PRESENT AT MEETING OF(1)..................................... OF..................................................................LIMITED Meeting held at..............................................................................on.........................................19..... | No. | Name | Represented by Signature of person attending | (2) Amount of proof lodged | | --- | ---- | -------------------------------------------- | -------------------------- | | | | | | (1) State whether creditors, members, contributories, debenture holders, or creditors and members. (2) In case of members or contributories, insert "number of shares" and "number of votes" according to the regulations of the company. Registered no.: COMPANIES FORM 128 Paragraph 577 (1) (e) Regulation 103 APPOINTMENT OF PROXY (1)\*I/\*We.....................................................................of......................................................................... a \*creditor/\*contributory/\*debenture holder/\*member of....................................................................... Limited, appoint (2).....................................................................................................................or in his absence ....................................................................................................as \*my/\*our\*general/\*special proxy to vote at the \*meeting of \*creditors/\*contributories/\*debenture holders \*members/\*joint meeting of members and creditors/\*meeting of the company and its creditors to be held on the...............................day of.....................................19.........or at any adjournment of that meeting.(3) Dated this...........................................day of........................................19........ (4)Signature............................................................... CERTIFICATE OF WITNESS(5) I,..................................................................of.......................................................................................... certify that the above instrument appointing a proxy was completed by me in the presence of and at the request of the person appointing the proxy and read to him before he attached his signature or mark to the instrument. Dated this.......................................day of........................................19........ Signature of witness.............................................................. Description............................................................................ Place of residence................................................................. (1) If a firm, strike out "I" and set out the full name of the firm. (2) Insert the name, address and description of the person appointed. (3) If a special proxy add the words "to vote for" or the words "to vote against" and specify the particular resolution. (4) The signature of the creditor, contributory, debenture holder or member is not to be attested by the person nominated as proxy. (5) This certificate is to be completed only where the person giving the proxy is blind or incapable of writing. \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ Registered no.: COMPANIES FORM 129 Paragraph 577 (1) (f) Sub-regulation 111 (2) NOTICE TO SUBMIT PARTICULARS OF DEBTS OR CLAIMS Take notice that creditors of the company, whose debts or claims have not already been admitted, are required on or before the........................day of.........................................19..........to submit particulars of their debts or claims and of any security held by them to me and, if subsequently required by notice in writing from me, shall formally prove their debts or claims and establish any title they may have to priority by statement in writing. In default of complying with this notice they will be excluded from the benefit of any distribution made before their debts or claims are proved or their priority is established and from objecting to the distribution. Signature of liquidator.................................................... Address.......................................................................... …………………………………………… Registered no.: COMPANIES FORM 130 Paragraph 577 (1) (f) Sub-regulation 120 (2) NOTICE INVITING FORMAL PROOF OF DEBT OR CLAIM .........................................................Limited Take notice that creditors of the company, whose debts or claims have not already been admitted, are required on or before the....................................day of........................................19........to prove their debts or claims and to establish any title they may have to priority by delivering or sending through the post to me at my address a formal proof of debt or claim in accordance with Form 131 or 132 containing their respective debts or claims. In default they will be excluded from the benefit of any distribution made before their debts or claims are proved or their priority is established and from objecting to the distribution. Form of proof may be obtained from me. Dated this...................................day of...................................19......... Signature of Liquidator............................................... Address....................................................................... ………………………………………………… Registered no.: COMPANIES FORM 131 Paragraph 577 (1) (f) Sub-regulation 121 (2) FORMAL PROOF OF DEBT OR CLAIM (GENERAL FORM) To the liquidator of......................................................................................................................Limited 1\. This is to state that the company was at the (').............................................day of......................... 19.........and still is, justly and truly indebted to (2)..............................................................................of ........................................................in the sum of......................................dollars and...................cents. Particulars of the debt are <table cellspacing="0" cellpadding="0" style="width:488.25pt; margin-left:2pt; border-collapse:collapse"><tbody><tr style="height:17.3pt"><td style="width:84.65pt; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:2pt; padding-left:2pt; vertical-align:middle">Date</td><td colspan="3" style="width:126.95pt; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:2pt; padding-left:2pt; vertical-align:middle">(3) Consideration</td><td colspan="3" style="width:41.9pt; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:2pt; padding-left:2pt; vertical-align:middle"></td><td colspan="4" style="width:73.4pt; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:2pt; padding-left:2pt; vertical-align:middle">Amount</td><td colspan="3" style="width:61.25pt; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:2pt; padding-left:2pt; vertical-align:middle"></td><td colspan="2" style="width:76.1pt; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:2pt; padding-left:2pt; vertical-align:middle">(4) Remarks</td></tr><tr style="height:43.7pt"><td style="width:84.65pt; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:2pt; padding-left:2pt; vertical-align:top"></td><td colspan="2" style="width:39.2pt; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:2pt; padding-left:2pt; vertical-align:top"></td><td style="width:83.75pt; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:2pt; padding-left:2pt; vertical-align:top"></td><td colspan="3" style="width:41.9pt; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:2pt; padding-left:2pt; vertical-align:top"></td><td style="width:33.35pt; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:2pt; padding-left:2pt; vertical-align:top">$</td><td colspan="3" style="width:36.05pt; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:2pt; padding-left:2pt; vertical-align:top">c</td><td colspan="3" style="width:61.25pt; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:2pt; padding-left:2pt; vertical-align:top"></td><td colspan="2" style="width:76.1pt; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:2pt; padding-left:2pt; vertical-align:top"></td></tr><tr style="height:29.85pt"><td colspan="16" style="width:484.25pt; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:2pt; padding-left:2pt; vertical-align:middle">FOR OFFICE USE ONLY</td></tr><tr style="height:19.9pt"><td colspan="2" style="width:117.5pt; border-top:0.75pt solid #000000; padding-right:2pt; padding-left:2pt; vertical-align:middle">Received</td><td colspan="3" style="width:95pt; border-top:0.75pt solid #000000; padding-right:2pt; padding-left:2pt; vertical-align:middle"></td><td colspan="5" style="width:90.5pt; border-top:0.75pt solid #000000; padding-right:2pt; padding-left:2pt; vertical-align:middle">Admitted to vote for</td><td colspan="2" style="width:28.85pt; border-top:0.75pt solid #000000; padding-right:2pt; padding-left:2pt; vertical-align:middle"></td><td style="width:53.15pt; border-top:0.75pt solid #000000; padding-right:2pt; padding-left:2pt; vertical-align:middle"></td><td colspan="3" style="width:79.25pt; border-top:0.75pt solid #000000; padding-right:2pt; padding-left:2pt; vertical-align:middle">Admitted to rank for dividend</td></tr><tr style="height:35.75pt"><td colspan="2" style="width:117.5pt; border-bottom:0.75pt solid #000000; padding-right:2pt; padding-left:2pt; vertical-align:top"></td><td colspan="3" style="width:95pt; border-bottom:0.75pt solid #000000; padding-right:2pt; padding-left:2pt; vertical-align:top"></td><td style="width:36.5pt; border-bottom:0.75pt solid #000000; padding-right:2pt; padding-left:2pt; vertical-align:top">$</td><td colspan="3" style="width:48.65pt; border-bottom:0.75pt solid #000000; padding-right:2pt; padding-left:2pt; vertical-align:top">c</td><td colspan="3" style="width:30.2pt; border-bottom:0.75pt solid #000000; padding-right:2pt; padding-left:2pt; vertical-align:top"></td><td style="width:53.15pt; border-bottom:0.75pt solid #000000; padding-right:2pt; padding-left:2pt; vertical-align:top"></td><td colspan="2" style="width:32pt; border-bottom:0.75pt solid #000000; padding-right:2pt; padding-left:2pt; vertical-align:top">$</td><td style="width:43.25pt; border-bottom:0.75pt solid #000000; padding-right:2pt; padding-left:2pt; vertical-align:top">c</td></tr><tr style="height:0pt"><td style="width:88.65pt"></td><td style="width:32.85pt"></td><td style="width:10.35pt"></td><td style="width:87.75pt"></td><td style="width:0.9pt"></td><td style="width:40.5pt"></td><td style="width:4.5pt"></td><td style="width:37.35pt"></td><td style="width:10.8pt"></td><td style="width:1.35pt"></td><td style="width:27.9pt"></td><td style="width:4.95pt"></td><td style="width:57.15pt"></td><td style="width:3.15pt"></td><td style="width:32.85pt"></td><td style="width:47.25pt"></td></tr></tbody></table> ``` 2. The creditor has not, nor has any person by the creditor's order, to my knowledge or belief, had or received any manner of satisfaction or security for the sum or any part of it except for the following:(5) (6) \*3. I am in the employment of the creditor and duly authorized in writing by the creditor to make this statement and it is within my knowledge that the debt was incurred for the consideration stated and that debt, to the best of my knowledge and belief, still remains unpaid and unsatisfied. (6)\*3. I am the creditor's agent duly authorized in writing to make this statement in writing and it is within my own knowledge that the debt was incurred and for the consideration stated and that debt, to the best of my knowledge and belief, still remains unpaid and unsatisfied. Dated this.................................day of.................................19......... Occupation....................................................................... Address............................................................................ (1) Insert date of court order in winding up by the Court, or date of resolution to wind up, if a voluntary winding up. (2) Insert full name and address of the creditor and, if applicable, the creditor's partners. If prepared by an employee or agent of the creditor, also insert a description of the occupation of the creditor. (3) Under "Consideration" state how the debt arose, for example "goods sold and delivered to the company between the dates of.............................................................", "moneys advanced in respect of the Bill of Exchange". (4) Under "Remarks" include details of vouchers substantiating payment. (5) Insert particulars of all securities held. Where the securities are on the property of the company, assess the value of those securities. If any bills or other negotiable securities are held, specify them in a schedule in the following form: <table cellspacing="0" cellpadding="0" style="margin-left:2pt; border-collapse:collapse"><tbody><tr style="height:18pt"><td style="width:113pt; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:2pt; padding-left:2pt; vertical-align:middle">Date</td><td style="width:109.85pt; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:2pt; padding-left:2pt; vertical-align:middle">Drawer</td><td style="width:96.8pt; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:2pt; padding-left:2pt; vertical-align:middle">Acceptor</td><td colspan="2" style="width:72.95pt; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:2pt; padding-left:2pt; vertical-align:middle">Amount</td><td style="width:75.65pt; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:2pt; padding-left:2pt; vertical-align:middle">Due date</td></tr><tr style="height:34.55pt"><td style="width:113pt; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:2pt; padding-left:2pt; vertical-align:top"></td><td style="width:109.85pt; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:2pt; padding-left:2pt; vertical-align:top"></td><td style="width:96.8pt; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:2pt; padding-left:2pt; vertical-align:top"></td><td style="width:34.25pt; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:2pt; padding-left:2pt; vertical-align:top">$</td><td style="width:34.7pt; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:2pt; padding-left:2pt; vertical-align:top">c</td><td style="width:75.65pt; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:2pt; padding-left:2pt; vertical-align:top"></td></tr></tbody></table> ``` (6) If proof is made by creditor personally, strike out the 2 paragraphs numbered 3. Registered no.: COMPANIES FORM 132 Paragraph 577 (1) (f) Sub-regulation 121 (3) FORMAL PROOF OF DEBT OR CLAIM ON BEHALF OF EMPLOYEES To the liquidator of.......................................................................................Limited I (1).....................................................................................................of (2).................................................., being (3)..................................................................................state 1. the company was, on the (4)................day of................19.....and still is, indebted to the persons whose names, addresses and descriptions appear in Columns 2, 3 and 4 in the Schedule to this proof of debt: 2. the indebtedness is in respect of wages, salaries, annual leave or long service leave, due to them in respect of services rendered by them while in the employment of the company during the periods set out in Column 5 against the names of the persons; 3. the indebtedness of the company to each person is for the amount set out in Column 6 against the name of that person; 4. those persons have not, nor has any of them, had or received any manner of satisfaction or security in respect of that indebtedness; 5\. I am authorized as.................., and the source of my information is as follows: | Column 1 | Column 2 | Column 3 | Column 4 | Column 5 | Column 6 | | -------- | --------------------- | -------- | ----------- | ------------------------------------------- | --------------- | | No. | Full name of employee | Address | Description | Period in respect of which claim is made(5) | Amount of claim | | | | | | | | Dated this.......................................day of.......................................19........ (1) Insert full name of person making the statement. (2) Insert full address of person making the statement. (3) Insert occupation of the person making the statement. (4) Insert date of court order in winding up, if winding up was by the Court, or date of resolution to wind up if a voluntary winding up. (5) In case of a claim for annual leave or long service leave, insert a description of the claim. Registered no.: COMPANIES FORM 133 Paragraph 577 (1) (f) Sub-regulation 126 (4) NOTICE AS TO REJECTION OF FORMAL PROOF OF DEBT OR CLAIM To......................................................................of........................................................................................... 1\. Your claim against the company asset out in the formal proof of debt or claim of (1)........................ ..................................................................made on the.......................................day of........................... 19………........has been \*wholly disallowed/\*disallowed to the extent of (2)....................../\*allowed in the sum of $........................................../\*allowed by me to the extent of your claim for (3)...................................... 2\. My grounds for disallowance of (4).........................................................................................are as follows 3\. If you are dissatisfied with my determination as set out above, you may appeal against it, no later than.........(5)days after the service of this notice, or within such further period as the Court allows, to the Supreme Court of.....................................................................................................If you do not do so, your claim will be assessed in accordance with my determination. Address.......................................................................... (1) Insert name of person submitting original proof of debt or claim. (2) Insert particulars of part of claim disallowed. (3) Insert particulars of part of claim allowed. (4) Insert particulars of part of claim referred to. (5) Insert number of days, being not less than 14. –––––––––––––– Registered no.: COMPANIES FORM 134 Paragraphs 577 (1) (g) and (ga) Regulation 130 PROVISIONAL LIST OF CONTRIBUTORIES The following is a provisional list of persons to be placed on the list of contributories made out by me from the records of the company, together with the number of their shares or the extent of their interest, their addresses and other particulars: