Unsecured Creditor's Claim

(Also for use by Preferential Creditors) SECTION 304 (1) COMPANIES ACT 1993 (For help see www.mvp.co.nz or email claims@mvp.co.nz)

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* Any personal information collected is for the purposes of administering the liquidation in accordance with the Companies Act 1993
The information will be used and retained by the liquidators and McDonald Vague and will be released to other parties only with your authorisation or in compliance with the Privacy Act 1993.
Under section 304(1) of the Companies Act 1993 any claim by an unsecured creditor against a company in liquidation must be in this prescribed form and must -

(a) Contain full particulars of the claim; and
(b) Identify any documents that evidence or substantiate the claim.
You may have access to and request correction of any personal information.
(*Not applicable, if creditor is not an individual within the meaning of the Privacy Act 1993.)

Name of Company in Liquidation: Mamapo Pologa Limited

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Note: (if the claim is made on behalf of creditor, specify relationship to creditor and authority) claim that the company was at the date it was put into liquidation indebted to the abovenamed creditor for the sum of*

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STATUS OF THE CLAIM:

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Note: (Also applicable to secured creditors who hereby surrender their security)

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My total claim is for

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(The liquidator may require the production of a document under Section 304(2) of the Companies Act 1993. You are not required to attach
any supporting documents at this stage, but you may attach them now, if you think it would expedite the processing of the claim.)

It is recommended that your claim is supported by documentation

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DETAILS OF CLAIM

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Please provide details of the basis of the retention of title claim fi led by you and/or details of entry on Personal Property Securities Register.

PREFERENTIAL CLAIMANTS ONLY

Guideline
The Seventh Schedule of the Companies Act 1993 sets out those claims which are regarded as preferential and shows their extent and order of priority. For example, wages and salary of an employee in respect of services rendered to the company during the four months preceding the commencement of liquidation are preferential AND the total sum to which priority is to be given in the case of any one employee for wages, holiday pay, deductions, redundancy and child support must not exceed $20,340 or such greater amount as is prescribed at the commencement of the liquidation.

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WARNING It is an offence under Section 304(6) of the Companies Act 1993 to -Make or authorise the making of, a claim that is false or misleading in a material particular knowing it to be false or misleading; orOmit, or authorise the omission from a claim of any matter knowing that the omission makes the claim false or misleading in a material particular.

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