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 Rule 4 34-CVL The Insolvency Act 1986                                                    Form 4 20




                                 5.95/99
 STATEMENT OF COMPANY'S AFFAIRS
 Pursuant to Section 95/99 of the insolvency Act 1986


                                                                      For official use




                                                                      Company Number

                                                                        08051374
To the Registrar of Companies Company Number



| SURESIGN (NW) LIMITED                                                                               ‘|

 |, M J Colman of Leonard Curtis, 20 Roundhouse Court, South Rings Business Park, Bamber
 Bridge, Preston, Lancashire, PR5 6DA, the Joint Liquidator of the above named Company,
 attach a statemeptettke              affairs as at 16 February 2015


                                                   Date      16 February 2015




 Presenter's name, address and reference (if
 any)


                                          For official use
 Leonard Curtis
 20 Roundhouse Court
 South Rings Business Park
 Bamber Bridge




 ore                                                                       win
 Preston



 For official use
                                                                                                           #378
                                                                                         eognot8
                                                                                   COMPANIES HOUSE
Rule 4 34-CVL                                                                                        Form 4 19




                    Statement of Affairs


                    Statement as to affairs of

                    SURESIGN (NW) LIMITED
                    on the 16 February 2015 being a date not more than 14 days before 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      jl LAE




                    Signed




                    Dated    MY.             tA,       ~LOIS”




CVLMF419 06-04-10
A- Summary of Assets


Assets
                                                                   Book Value       Estimated
                                                                                    to Realise
                                                                       £                £
Uncharged assets

Goodwill                                                               8,230                1,500
Plant and Machinery                                                     1,508               1,500
Motor Vehicles                                                         4,771                        -
Debtors                                                               24,725                        -
Cash at Bank                                                           1,798                1,798
Stocks                                                                60,000                1,000
Office Furniture and Equipment                                                  -           1,000




Estimated total assets avail     referential creditors                99,234             6,798



Signature                                                Date   / k 2-+ C
A1 - Summary of Liabilities


                                                                                       Estimated
                                                                                       to Realise
                                                                                            £
Estimated total assets available for preferential creditors                 99,234            6,798

Liabilities

Preferential creditors
Employee / Employment Rights Act 1996 Claims (est )                             Nil          (592)
Estimated (deficiency) / surplus as regards preferential creditors          99,234           6,206

Estimated prescribed part of net property where applicable (c f/wd)            N/A             N/A
Estimated total assets available for floating charge creditors              99,234           6,206

Debts Secured by floating charges

Estimated surplus of assets after floating charges                          99,234           6,206

Estimated prescribed part of net property where applicable (b fiwd)            N/A             NA
Total assets available to unsecured creditors                               99,234           6,206

Unsecured non-preferential claims (excluding any shortfall to floating
charge holders)
Employee / Employment Rights Act 1996 Claims (est )                         (1,640)
H M Revenue & Customs — Corp Tax (est )                                     (5,502)
H M Revenue & Customs - PAYE / NI (est )                                        (93)
H M Revenue & Customs — VAT (est )                                          (1,707)
Trade and Expense Creditors (est }                                              (46)       (8,988)
Estimated deficiency as regards non-preferential creditors                                 (2,782)

Shortfall to floating charge holders (b/fwd)                                                   NIA
Estimated (deficiency) / surplus as regards creditors                                      (2,782)

Issued and called up share capital
100 shares of £1 each                                                                         100
Estimated (deficiency) / surplus as regards members                                        (2,882)



Signature                                                     Date       [b-IAK
                                                                      COMPANY CREDITORS
Note: You must include all creditors and identify all creditors under hire-purchase, chattel leasing or conditional sale agreements and customers claiming
amounts paid in advance of the supply of goods or services and creditors claiming retention of title over property in the company’s possession
 Name of creditor                               Address                          Amount | Details of any security held by | Date security |            Value of security
   or Claimant                              (with postcode)                      of debt              creditor                  given                          £
                                                                                    £
See attached
                                                   x)
                                Signature                                                         Date [b-      2-1f
                                            Za
 B - Company Creditors
 SA12M Suresign (NW) Limited

 Code                 Name & Address                                                 Amount of Debt

 c0001                MB Keehan                                                                   100
                      23 Wyreside Drive
                      Hambleton
                      Poulton-Le-Fylde
                      Lancashire
                      FY6 9DP
 c0002                HM Revenue & Customs (VAT)                                             1,707 00
                      National Insolvency Unit
                      5th Floor Regian House
                      James Street
                      Liverpool
                      L75 1AD
C0003                 HM Revenue & Customs (Corporation Tax)                                 5,502 40
                      Insolvency Claims Handling Unit
                      Benton Park View
                      Longbenton
                      Newcastle
                      NE98 12ZZ
C0004                 HM Revenue & Customs (PAYE)                                              92 80
                      Durrington Bridge House
                      Barrington Road
                      Worthing
                     West Sussex
                     BN12 4SE
C0005                The Insolvency Service                                                   592 00
                     Redundancy Payments
                     PO Box 15424
                     Cobalt Square
                     83-85 Hagley Road
                     Birmingham
                     B16 8QG
C0006                United Utilities                                                           100
                     PO Box 50
                     Warrington
                     WA55 1AQ
C0007                British Telecommuications plc                                              100
                     81 Newgate Street
                     London
                     ECIA 7AJ
c0008                npower                                                                     100
                     PO Box 583
                     Hull
                     HUS5 1YU
c0009                Santander                                                                 42 25
                     PO Box 1109
                     Bradford
                     BDi 52J
co010                The Insolvency Service                                                 1,640 00
                     Redundancy Payments
                     PO Box 15424
                     Cobalt Square
                     83-85 Hagley Road
                     Birmingham
                     B16 80G


                     Signature                                    Date   [b- LZNS*
                                              ma,
SA12M    ~~                                          Page   1/2
 B - Company Creditors
SA12M   Suresign (NW) Limited

Code                   Name & Address         ‘                        Amount of Debt

                                                                              £9,580 45




                      Signature                         Date /6-L-K~


SA12M     oe        Coo           Lo    .   Page 2/ 2              _
                                                       COMPANY SHAREHOLDERS
      Name of Shareholder                             Address (with postcode)                      No. of shares |   Nominal   Detatls of Shares held
                                                                                                       held           Value
            Roger Garside        7 St Martins Close, Carleton, Poulton-Le-Fyide, Lancashire,           100             100            Ordinary
                                 FY6 7NT
                            NS
                                                                                          TOTALS       100             100
Signature                                                                Date   [ b- -2-/ «
                       a