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                                                                             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-