Form 4.20 S.95/99 The Insolvency Act 1986 Statement of Company’s Affairs Pursuant to Section 95/99 of the Insolvency Act 1986 To the Registrar of Companies [Company Number 1843261 Name of Company WELFORM LIMITED We Philip Anthony Brooks and Julie Willetts Blades Insolvency Services Charlotte House 19B Market Place Bingham Nottingham NG13 8AP the liquidators of the above named company attach a statement of the company’s affairs as at 8 December 2010 For Offict se Mil tM | Liquidation Sect PHQ: AgS 24/12/2010 49 COMPANIES HOUSE Rule 4.34 - CVL Form 4.19 Statement of Affairs Statement as to affairs of WELFORM LIMITED on the 8 December 2010 the date of the resolution for winding up Affidavit This Affidavit must be sworn or affirmed before a Solicitor or Commissioner of Oaths when you have completed the rest of this form. a) Insert name and I (a) Michelle Ritchie-Quinney occupation Company Director b) Insert full of (b) 8 Kings Brook Close address Rempstone Leicestershire LEI2 6RR Make oath and say that the several pages exhibited hereto and marked _- are to the best of my knowledge and belief a full, true and complete statement as to the affairs of the above named company as at 8 December 2010 the date of the resolution for winding up and that the said company carried on business as metal fabricators Sworn at LG Crow sect Bins Clr, : 5 Ne? 7 ¢~4 GIA Dae &" Decemager Qore Signatures(s) Before me_ “2 BASS JCB CA OC} Aco 77 A Sohcitor omGerrmsstattemoroaths Before swearing the affidavit the Solicitor or Commissioner is particularly requested to make sure that the full name, address and description of the Deponent are stated, and to initial any crossings- out or other alterations in the printed form. A deficiency in the affidavit in any of the above respects will mean that it is refused by the court, and will need to be re-sworn. A- Summary of Assets Assets Book Estimated to Value Realise £ £ Assets specifically pledged Assets not specifically pledged:- Cash at Bank 97,500 97,500 Funds held on Trust 16,000 16,000 Debtors $3,000 20,000 Estimated total assets available for preferential creditors £ 176,500 133,500 Signature ( AN fr Date _O8 Liad l= NvY < A Al - Summary of habilities Estimated to realise é Estimated total assets available for preferential creditors (carried from Page A) 133,500 Liabilities Preferenual Creditors - . Estimated surplus as regards preferential creditors 133,500 Estumated prescribed part of net property where applicable (to carry forward) - Estimated total assets available for floating charge holders 133,500 Debts secured by floating charges - Estimated surplus of assets after floating charges 133,500 Esumated prescribed part of net property where applicable (brought down) - Total assets available to unsecured creditors 133,500 Unsecured non-preferential claims (excluding any shortfall to floating charge holders) Trade and expense creditors (per listing) 96,235 H M Revenue and Customs - PAYE/NI 2,900 H M Revenue and Customs - Corporation Tax 19,461 Employee claims - redundancy and pay in lieu $,600 124,196 Estimated surplus as regards non-preferential creditors (excluding any shortfall to floating charge holders) 9,304 Shortfall to floating charge holders (brought down) - Estimated surplus as regards creditors 9,304 issued and called up capital | ordinary shares of £1 00 each | Estimated total surplus as regards members 9,305 Signature : Date [a] afr 2fl2 WELFORM LIMITED LIST OF CREDITORS Name Address Amount Owed AH Allen Steel Services £27,941 75 Downing Road West Meadows Ind Estate Derby DE21 6HA Aobey Steels £6,039 97 Unit 29, Wolverhampton Central Trading Estate Cable Street Wolverhampton WV2 2HX Aspect Powder Coatings Ltd £3,982 80 Aspect House Coneygrey Ind Estate Birmingham New Road Tipton DY4 8XP Banbury Piastic Fittings Ltd £350 43 Unit 13 Overfield Thorpe Way Ind Estate Banbury Oxon OX16 4XR Cnarnwood Fasteners Ltd £592 21 Units F27/30 Cumberland Trading Estate Loughborough Leics LE11 5DF Citadel £282 00 Units F4 Halesfield 4 Telford Shropshire TF7 4AP D Quinney £2,000 00 8 Kingsbrook Close Rempstone Leicestershire ozs Name Address Amount Owed LE126RR East Anglian Galvanising Ltd £419 95 Stafford Street Wiltenhall Staffordshire WV13 1RZ East Midiands Welding Co Ltd £19 82 Baker Brook Ind Estate Wigwam Lane Hucknall Nottm NG15 7SZ Edward Howell Galvanizers Ltd £9,096 77 Watery Lane Wednesfield West Midlands WV13 3SU F H Brundle £3,703 16 Condor Road Quarry Hill Ind Estate (Ikeston Derbys DE7 4RE Foster Industrial £2,787 49 c/o RBS Invoice Finance ltd Smith House, PO Box 50 Elmwood Avenue Feltham TW13 7QD Frank Hand Galvanisers £968 98 c/o RBS Invoice Finance Ltd Smith House, PO Box 50 Elmwood Avenue Feltham TW13 7QD Fuel Card Services Limited £573 67 Alexandra House Lawnswood Bus Park Redvers Close Leeds LS16 6QY osfi2fl- Name Address Amount Owed K R Saws Limited £146 22 Unit A2, Abbey ind Est Bodmin Road Coventry CV2 5DB Lee Brothers £126 90 Wellington Cottage Main Street Thornton Leics LE67 1AG Leicester Laser Limited £152 75 8 Layton Road Leicester LES OPU Metatec Limited £180 86 Fitzherbert Road Farlington Portsmouth Hants PO6 1RU MHT Developments £100 00 Unit 16 Market Street Ind Estate Coalville Leicestershire Midland Metal Sawing Services £493 27 Old Station Close Coalville Letcestershire LE67 3FH New Star Powder Coating £1,277 20 Clo HSBC Invoice Finance Farncombe Road Worthing BN11 2BW PHencing Systems Limited £2,184 54 1-3 Leicester Road 08/12> Name Address Amount Owed Shepshed Leicester LE12 9DF Pitchford Steelstock Limited £6,640 66 Pedmore Road Ind Estate Brierley Hill West Midlands DY5 1TH Piatinum Steelworks Limited £122 20 2 Fernhurst Road Leicester LE3 2PG Precision Fencing £176 25 17 Benscliffe Drive Loughborough Leicester LE11 3JP Sage UK Limited £11163 North Park Newcastle upon Tyne NE13 9AA Save Money On Callls £116 69 514 Chester Road Castle Bromwich Birmingham B36 OLG SMF (UK) Limited £3,535 68 2 Victoria Street Syston Leicester LE7 2LF Stoke Galvanising Limited £21,454 41 Nevade Lane Burslem Stoke on Trent ST6 2BN O82 Name Address Amount Owed Tunley Rod & Bar (Decotters) Ltd £656 59 Unit 22, Cobbett Road Zone 1, Burntwood Bus Park Burntwood Staffs WS7 3GL £96,234 85 of/i2 [7 s-