Basis for Claim Sample Clauses

Basis for Claim. Attached as Annex A hereto is a full, complete and accurate description in all material respects, together with any material applicable underlying documents (including, without limitation, court orders, settlement agreements, fines and bills) of the factual circumstances giving rise to the Losses to which the Claim relates.

Basis for Claim. 9.5.1 The Seller Warranties other than the Fundamental Seller Warranties shall not survive Completion. After Completion, the Purchaser shall not have any right or ability to make any Claim that any Seller Warranty other than the Fundamental Seller Warranties has been breached, is untrue, inaccurate or misleading, other than in respect of the fraud or wilful misconduct by the Seller, its agents or advisors.

Basis for Claim. Breach of Contract, Declar Relief, Prelim Injunct, Negligence (See instruction #2) 3. Last four digits of any number by which creditor identifies debtor: 6 3 1 5 3a. Debtor may have scheduled account as: 137,400.12 (See instruction #3a) 3b. Uniform Claim Identifier (optional): (See instruction #3b) Amount of arrearage and other charges, as of the time case was filed, 4. Secured Claim (See instruction #4) included in secured claim, if any: Check the appropriate box if the claim is secured by a lien on property or a right of setoff, attach required redacted documents, and provide the requested information. $ Nature of property or right of setoff: ❐✔Real Estate ❐Motor Vehicle ❐Other Basis for perfection: see xxxxxxx.xxx below Describe: Value of Property: $ 465,000.00 Amount of Secured Claim: $ Annual Interest Rate % ❐Fixed or ❐Variable Amount Unsecured: $ (when case was filed) 5. Amount of Claim Entitled to Priority under 11 U.S.C. § 507 (a). If any part of the claim falls into one of the following categories, check the box specifying the priority and state the amount. ❐ Domestic support obligations under 11 ❐ Wages, salaries, or commissions (up to $11,725*) ❐ Contributions to an U.S.C. § 507 (a)(1)(A) or (a)(1)(B). earned within 180 days before the case was filed or the employee benefit plan – debtor’s business ceased, whichever is earlier – 11 U.S.C. § 507 (a)(5). 11 U.S.C. § 507 (a)(4). Amount entitled to priority: ❐ Up to $2,600* of deposits toward ❐ Taxes or penalties owed to governmental units – ❐ Other – Specify $ purchase, lease, or rental of property or 11 U.S.C. § 507 (a)(8). applicable paragraph of services for personal, family, or household 11 U.S.C. § 507 (a)( ). use – 11 U.S.C. § 507 (a)(7). *Amounts are subject to adjustment on 4/1/13 and every 3 years thereafter with respect to cases commenced on or after the date of adjustment. 6. Credits. The amount of all payments on this claim has been credited for the purpose of making this proof of claim. (See instruction #6) B 10 (Official Form 10) (12/12) 2 email: Telephone number: (Date) July 8, 2013 /S/ Xxxx Xxxxxx (Signature) 16money.html?pagewanted=all& Address and telephone number (if different from notice address above): xxxx://xxx.xxxxxxx.xxx/2010/10/16/your-money /mortgages/16money.html?pagewanted=all& 2010/10/16/your-money/mortgages/ Title: Company: I declare under penalty of perjury that the information provided in this claim is true and correct to the best of my knowledge, information, and r...

Basis for Claim. State the type of debt or how it was incurred. Examples include goods sold, money loaned, services performed, personal injury/wrongful death, car loan, mortgage note, and credit card. If the claim is based on delivering health care goods or services, limit the disclosure of the goods or services so as to avoid embarrassment or the disclosure of confidential health care information. You may be required to provide additional disclosure if an interested party objects to the claim.