, Form 4 20 Rule 4 34-CVL The Insolvency Act 1986 Statement of Company's Affairs Pursuant to section 95/99 of the Insolvency Act 1986 For Official Use To the Registrar of Companies Company Number 02122529 Name of Company CIB (Life & Pensions) Limited |/We Eric Walls, C12 Marquis Court, Marquisway, TVTE, Gateshead, Tyne & Wear, NE11 ORU Wayne Harrison, C12 Marquis Court, Marquisway, TVTE, Gateshead, Tyne & Wear, NE ORU the liquidator(s) of the above named company attach a statement of the company affairs as at 14 May 2015 Signed / Lill Date 14 May 2015 | | sem KSA Group Ltd | | MTT C12 Marquis Court | 18/05/2015 #! Ref K2533/EWWH COMPANIES HOUSE Software Supplted by Turnkey Computer Technology Limited Glasgow Rule 4 34-CVL Form 4 19 Statement of Affairs Statement as to affairs of C 1B (Life & Pensions) Limited on the 14 May 2015 the date of the resolution for winding up Statement of truth ! believe that the facts stated in this Statement of Affairs are true Full Name —— DAs} ‘ Signed Dated C IB (Life & Pensions) Limited Statement Of Affairs as at 14 May 2015 A - Summary of Assets Estimated to Assets Book Value Realise £ £ Assets subject to fixed charge Assets subject to floating charge: Uncharged assets: Funds Held by the Liquidators 7,200 00 7,200 00 Book Debts 4,303 12 648 14 Cash at Bank 47,607 67 17,607 67 Pension Book Yield 100 100 Estimated total assetsivatlable for preferential creditors 25,456 81 Date \ WS - = \S C 1B (Life & Pensions) Limited Statement Of Affairs as at 14 May 2015 Ai - Summary of Liabilities Estimated to Realise £ Estimated total assets available for preferential creditors (Carried from Page A) 25,456 81 Liabilities Preferential Creditors - NIL Estimated deficiency/surplus as regards preferential creditors 25,456 81 Debts secured by floating charge pre 15 September 2003 Other Pre 15 September 2003 Floating Charge Creditors NIL 25,456 81 Estimated prescribed part of net property where applicable (to carry forward) NIL Estimated total assets available for floating charge holders 25,456 81 Debts secured by floating charges post 15 September 2003 NIL Estimated deficiency/surplus of assets after floating charges 25,456 81 Estimated prescribed part of net property where applicable (brought down) NIL Total assets available to unsecured creditors 25,456 81 Unsecured non-preferential claims (excluding any shortfall to floating charge holders) Claimants with Final Decision Obtained 27,758 01 Associated Creditors 4,285 02 HM Revenue & Customs -EFRBS (Contingent) 113,000 00 Contingent Creditors- P] Ciaims 463,213 84 608,256 87 Estimated deficiency/surplus as regards non-preferential creditors (excluding any shortfall in respect of F.C's post 14 September 2003) (582,800 06) Estimated deficiency/surplus as regards creditors (582,800 06) Issued and called up capital Ordinary Shareholders 10,000 00 10,000 00 Estimated total deficiensy/surplus as regards members (692,800 06) oO Signature 7 Date \ yr Os S U1 (Lite & Pensions) Limited Statement Of Affairs as at 14 May 2015 B - List of Creditors Claimant with Final Decision Obtained Name Address £ Mr D Bucknall nia 27,758 01 Sub Total 27,758 01 Associated Creditors Name Address £ CIB Wealth Management LLP Beta House, Laser Quay, Culpepper Close, Rochester, ME2 4HU 2,960 48 Real SIPP LLP Beta House, Laser Quay, Culpepper Close, Rochester, ME2 4HU 1,324 54 Sub Total 4,285 02 Contingent Unsecured Creditors Name Address £ Mr C Barrows n/a 8,213 84 Mr G Trodden nla 5,000 00 Mr J Rhea na 150,000 00 Miss A Smith na 5,000 00 Mrs A Winerbourne a 45,000 00 The Financial Ombudsman Exchange Tower, London, E14 9SR 250,000 00 HM Revenue & Customs (EFRBS) Counter- Avoidance Team, PO Box 30002, Glasgow, G70 6AG 113,000 00 Sub Total 576,213 84 Total 608,256 87 Signature