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 02609058 Name of Company Formula Business Forms Limited |/We Scott Christian Bevan, 45 Church Street, Birmingham, B3 2RT Simon David Chandler, 45 Church Street, Birmingham, B3 2RT the liquidator(s) of the above named company attach a statement of the company affairs as at 13 May 2015 Signed Date 13 May 2015 ne ; =a Mazars LLP 45 Church Street For Official Use HEATON Birmingham In Ref FORMULA/scb/SDC/EH/HZB/AZH 18/05/2015 #109 Software Supplied by Tumkey Computer Technology Limited Glasgow COMPANIES HOUSE Rule 4 34-CVL Form 4 19 Statement of Affairs Statement as to affairs of Formula Business Forms Limited on the 13 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 J hme Can nh Signed S15 Dated \2,| OF | t s Formula Business Forms Limited Statement Of Affairs as at 13 May 2015 A- Summary of Assets Estimated to Assets Book Value Realise £ £ Assets subject to fixed charge Book Debts 401,888 93 304,011 61 Lloyds Bank Commercial Finance (331,474 16) Deficiency c/d (27,462 55) Plant & Machinery 185,102 00 70,000 00 Liberty Leasing Limited (71,621 00) Deficiency c/d (1,621 00) Assets subject to floating charge Plant & Machinery 2,000 00 500 00 Furniture & Equipment 272 00 NIL Uncharged assets’ Estimated total assets available for preferential creditors 500 00 f Signature &—4, Date 12/ Osis Formula Business Forms Limited Statement Of Affairs as at 13 May 2015 A1 - Summary of Liabilities Estimated to Realise £ Estimated total assets available for preferential creditors (Carried from Page A) 500 00 Liabilities Preferential Creditors - Employees Wage Arrears & Holiday Pay 23,302 02 23,302 02 Estimated deficiency/surplus as regards preferential creditors (22,802 02) Debts secured by floating charge pre 15 September 2003 Other Pre 15 September 2003 Floating Charge Creditors NIL (22,802 02) Estimated prescribed part of net property where applicable (to carry forward) NIL Estimated total assets available for floating charge holders (22,802 02) Debts secured by floating charges post 15 September 2003 NIL Estimated deficiency/surplus of assets after floating charges (22,802 02) Estimated prescribed part of net property where applicable (brought down) NIL Total assets available to unsecured creditors (22,802 02) Unsecured non-preferential claims (excluding any shortfall to floating charge holders) Deficiency b/d 29,083 55 Trade & Expense Creditors 274,523 60 Employees Redundancy Pay & Lieu of Notic 88,787 92 HMRC re VAT 72,254 02 HMRC re PAYE/NI 32,482 71 497,131 80 Estimated deficiency/surpius as regards non-preferential creditors (excluding any shortfall in respect of F.C’s post 14 September 2003) (519,933 82) Estimated deficiency/surplus as regards creditors (519,933 82) Issued and called up capital Ordinary Shareholders 100 00 100 00 Estimated total deficiency/surplus as regards members (520,033 82) Signature Date !S | os is Mazars LLP Formula Business Forms Limited A2 - Secured Creditors Statement of Affairs Figures Key Name £ CLO2 Liberty Leasing 71,621 00 Liberty House Brook Avenue Warsash Southampton SO31 9HP CLO3 Lloyds Bank Commercial Finance Limited 331,474 16 No | Brookhill Way Banbury Oxon OX16 3EL 2 Entries Totalling 403,095.16 Signature Mazars LLP Formula Business Forms Limited A4 - Preferential Creditors Statement of Affairs Figures Key Name £ CEO! Employees 23,302 02 1 Entries Totalling 23,302 02 Signature Sa: A Mazars LLP Formula Business Forms Limited AS - Unsecured Creditors Statement of Affairs Figures Key Name £ C000 02 000 Correspondence Department, Houghton Regis PO Box 202 LU6 9AG CA00 Anca Industrial 209 46 Unit D4b Coombswood Business Park Coombswood Way Halesowen CAOI AA Packaging 1,850 69 Liverpool Road Walmer Bridge Preston Lancashire CA02 Automail Envelopes 316 80 Unit 10 Saltbrook Trading Estate Saltbrook Road Cradley Heath B63 2QJ CA03 Autoguard Alarms 727 20 125 Bridgenorth Road Wollaston Stourbridge West Mids DY8 3NX CA04 Active Carriers 6 258 60 46 Coneygre Ind Est Tipton DY4 8XF CAQS Allmake Rollers 632 40 Unit B, Index House Ty Coch Way Cwmbran Gwent NP44 7HB CA06 AmH Electronic Services 126 48 Unit 34b Dawley Trading Estate Stallings Lane Kingswinford CA07 AR Byng 1,935 00 Casa Mia Waresley Road Hartlebury Worcestershire DY11 7XT ¢ Signature Kes Mazars LLP Formula Business Forms Limited A5 - Unsecured Creditors Statement of Affairs Figures Key Name £ CA08 Antalis Ltd 120,327 66 Gateway House Interlink Way West Coalville Leics LE67 1LE CA09 ADT Fire Security 000 DD Administration , Security House The Summit Hanworth Road Sunbury-on-Thames Middlesex TW16 SDB CBO00 BFS Pressroom Solutions 183 96 5 Pincents Kiln Ind Est Pincents Lane Calcot Berks RG31 78D CBO1 Blue Mountain water 4074 PO Box 4104 Birmingham B16 8DQ CBO2 Britush Telecom 305 15 Insolvency Unit, Department W Durham TE Providence Row Durham DH! IRR CBO03 Black Country Pallets 855 00 GONE AWAY Ccco0 Charter Business Forms 2,202 37 Umit 12b Harris Ind Park Hanbury Road Stoke Pnor Bromsgrove B60 4AD ccol Corrugated Box Supplies 2,884 05 Swaran House Kelvin Way West Bromwich B70 7LG CC02 CP Graphics 1,904 27 Unit 89 Leyland Ind Est Irthlngborough Road Wellingborough Northampton Signature { rs Mazars LLP Formula Business Forms Limited AS - Unsecured Creditors Statement of Affairs Figures Key Name CC03 City Electrical Factors 115 78 Midland Division 1 Alpha House Farmer Ward Road Kenilworth CV8 2 ED CC04 Terry Cooper Services (1985) 50 50 85 Armold Road Basford Nottingham NG6 0EE CD00 DF Logistics Solutions Ltd 168 00 Crown Works Anne Road Smethwick Birmingham CD01 Devaneys Haulage Ltd 1,398 00 Ryders Green Road West Bromwich B70 CD02 Digital Copiers Direct Ltd 152 48 33 Durston Close Amungton Tamworth B77 3QG CD03 Dudley MBC 000 Revenue Services PO Box 3 Dudley DY! 1HG CE0O E-On 1,966 50 Gniffin Court Pheontx Bus Park Nottingham NG8 6AT CEO1 Employees 88,787 92 CFO00 FRIP Finishing Ltd 1,216 43 Unit 6 Sterling Park Jacknell Road Dodwells Bridge Ind Est Hinckley Leics LE10 3BS CFO1 Fellgrind Limited 403 20 14 Izons Ind Est Oldbury Road West Bromwich B70 SBS ‘ Signature Ge Mazars LLP Formula Business Forms Limited A5 - Unsecured Creditors Statement of Affairs Figures Key Name CFO02 First Found 000 St James Buildings Oxford Street Manchester M1 6FQ CG00 Green Street Bindery 1,800 72 Horspath Trading Centre Pony Road Oxford OX4 2RD CG01 Greenwood & Co 0 00 16 Birmingham Road Walsall WS12NA CHO00 H M Revenue & Customs 72,254 02 National Insolvency Unit Sth Floor Regian House James Street Liverpool L75 1AD CHO1 HM Revenue & Customs 32,482 71 Room BP3202, Warkworth House Benton Park View Longbenton Newcastle upon Tyne NE98 1Z2Z C100 TIntuprint Ltd 816 11 Tame Valley Industrial Estate Wilnecote Tamworth B77 5DQ Cl01 Intuitrve Computer Management 2,142 04 Cradley Enterprise Centre Maypole Fields Halesowen C102 ING Lease 000 60 High Street Redhill Surrey RH1 INY C100 John Price Printers 2,485 20 Brook Street Bilston WV14 ONW r Signature (a ’ Mazars LLP Formula Business Forms Limited A5 - Unsecured Creditors Statement of Affairs Figures Key Name £ CJOl JF Machines 1,099 20 Unit 4 Cross Court Ind Est Cross St Kettering Northants NN16 9BN CK00 Kennedy Grinding Ltd 297 96 Unit 1 Shrewsbury Road Craven Arms Shropshire SY7 9QH CKOI Konica Minolta Business Solutions 4,145 05 Miles Gray Road Basildon Essex SS14 3AR CK02 KD Electrical Co Ltd 1,573 22 Lyde Green Cradley Halesowen B63 2PG CKO3 Phil Knights 129 00 2 The Croft Old Road Wittington Worcestershire CLOO Litho Supplies (UK) Ltd 1,182 92 Units 1-2 Ashbourne Court, Manners Avenue Manners Ind Est Ilkeston Derbyshire De? 8EF CLO1 Lowes Transport (B'ham) Ltd 1,234 80 Powke Lane Rowley Regis Warley B65 OAL CM00 Midwest Fork Lift Services 2,604 00 Blackheath Trading Est Cakemore Road Rowley Regis Warley CM01 AJ Mucklow & Co Ltd 9,405 00 60 Whitehall Road Halesowen B63 3JS Signature c ‘ tH Mazars LLP Formula Business Forms Limited AS - Unsecured Creditors Statement of Affairs Figures Key Name £ CM02 Masart Print & Design 13,869 84 24 Sunbury Road Halesowen B63 4DH CM03 MNB Mould Services Ltd 6,648 00 Unit 2B, Tamebridge Ind Est Aldndge Road Perry Barr Birmingham B42 2TX CM04 Mercedes Benz Finance 000 Tongwell Milton Keynes MKI15 8BA CM05 Marlowe Digital 000 20 Abbotts Business Park Primrose Hill Kings Langley Hertfordshire WS4 8FR co00 Johnson Oils 770 96 Suite 12 Vision Point Vaughan Trading Estate Sedgley Road East Tipton CP00 Premmer Paper Group 50,298 S56 Midpoint Park Kingsbury Road Minworth Birmingham B76 1AF CPOl PTS Castleford 1,442 97 Gilcar Way Wakefield Europort Castleford WF10 5QS CROO Rentokil 106 59 GONE AWAY CROI Red Hot Vending 400 60 31/33 Reform Street Freetown Way Hull E Yorks CRO2 RM (Rotary Services) Ltd 1,287 08 New Lane Havant Hampshire POS 2LT Signature Ly Mazars LLP Formula Business Forms Limited AS - Unsecured Creditors Statement of Affairs Figures Key Name £ CRO3 Reel Print (Register Sets) Ltd 2,734 80 Unit 13 Lanesfield Drive Off Spring Road Wolverhampton WV4 6UA CS00 SITA uk Ltd 329 45 301-303 Parkway Worle Weston-Super-Mare BS22 6WA CSOl South Staffs Water (49 21) Green Lane Walsall WS2 7PD CS02 Service Offset Supplies Ltd 4,667 58 Oakwood Hill Ind Est Oakwood Hill Loughton Essex 1G10 3TZ CS03 Solas uk Ltd 139 75 GONE AWAY CS04 Springpack 274 75 Racecourse Road Pershore Worcestershire WRIO 2EY CSOs Sovereign Office Equipment 1,402 23 Unit 14 Mucklow Hill Trading Est Halesowen B62 8DR CS06 Servaheat 682 25 Bagnall St Ind Est George Henry Road Great Bridge Tipton CS07 Screamers Ltd 916 20 Globe House Park Lane Halesowen B63 2RA CS08 Savory Paper Ltd 12,958 05 Soverign House Brackmills Northampton NN4 7JE Signature ff. , Mazars LLP Formula Business Forms Limited A5 - Unsecured Creditors Statement of Affairs Figures Key Name C809 Sage (UK) Limited North Park Newcastle Upon Tyne NE13 9AA CT0O Tooles Transport (2 00) Rushock Trading Est Droitwich Road Rushock Worcestershire cuoo United Eco Services Ltd 404 84 United House Spring Copse Business Park Shnfold Horsham West Sussex Cu0l UPS (94 03) UPS House Forest Road Feltham Middlesex TW13 7DY Cwo00 Warley Carriers 174 00 Oldbury Road West Bromwich B70 9DP cwol Whitethorne Graphics 14 40 41 Chadwell Heights Lichfield WS13 6BH 72 Entries Totaling 468,048.25 @ - Denotes associate creditor Signature