Claim Form for completion     

Guidance notes on claim form completion

1. Name of Creditor

Insert the name of the person to is owed money by the company.

2. Address of Creditor

Insert the full current address of the creditor.

3. Amount of Claim

Insert the total amount considered to be owed by the company to the creditor as at the date of appointment of the liquidator.

4. Uncapitalised interest

If the total amount of claim entered in box 3 includes any interest contractually payable, the amount should be entered here, calculated up until the date of the liquidation. This typically applies to loan and credit card agreements.

5. Details of whether any part of the claim is preferential

A claim is only deemed to be preferential, as defined in the Insolvency Rules 2005, if the creditors falls into one of the following categories:

• an employee of the company
• the BVI Social Security Board
• the Government of the Virgin Islands
• the Financial Services Commission

In addition, only certain categories of debts owed to the parties above are accepted as preferential. If any creditor believes they fall into one of the categories above, please contact a Kalo member of staff for further guidance.

6. Particular of how and when debt incurred

Enter details and how the company came to owe the claim, and details and when this was.

7. Details of any documents

Insert details of any documents available to support your claim. Typical examples will be: invoices, bank statements, contracts.

8. Particular of any security held

This section is for details of any security you may hold which your claim is secured against.  Typically, this will be relevant to financial institutions only. An example of this would be when a bank lends money to purchase a property, the bank will have a charge (mortgage) on the property. In the event of default, the bank are able to take possession of the property under the terms of their charge. In this scenario, the property would be the bank’s security.

9. Signature of the creditor or person authorized to act

The creditor named in box 1 should sign here and enter their name in CAPITAL letters. If the creditor is a company, the person signing on behalf of the company would also enter their position in relation to the creditor, e.g. director, manager, or secretary, along with their name in CAPITAL letters. If the address of the signatory is different to the address of that in box 2, this should also be entered here.