TO ALL CREDITORS IMPORTANT Kindly comply with the following requirements, when completing claim forms. 1. The affidavit for proof of claims must be completed in every detail and must be signed before a Commissioner of Oaths, ensuring the Commissioner inserts his/her FULL names and physical address. 2. A detailed Statement of Account must be attached to the claim. Where the claim is in respect of goods or services supplied, the Statement must include the monthly totals and a brief description of the purchases or services and payments for the full period of trading immediately before the date of commencement of Business Rescue namely 12 June 2018. For your convenience a statement is annexed which, if properly completed, will comply with the requirements of the Act. 3. Where an incorporated Company proves a claim, the Power of Attorney must be signed by a Director of any other person authorised by Resolution. A copy of such Resolution must be annexed to the Power of Attorney. A suitable form of Resolution is attached. Should you wish to make use of same, kindly complete it in full detail and return one copy with the claim documents. 4. If the claim is in respect of Promissory Notes, Bills of Exchange or cheques, the appropriate Affidavit must be completed, which is attached hereto and any Bills of Notes must be attached to the claim. 5. Where the claim is based upon a Mortgage or National Bond or Hire Purchase Agreement, a certified copy of the original Bond or Agreement must be filed with the claim together with a statement showing the amounts owing. 6. The Business Rescue Practitioner will not admit a claim in respect of cash lent unless a detailed statement is attached to the claim, reflecting the date when the cash was lent and any payments made on account thereof. It is also necessary to annex to your claim all supporting documents or vouchers in respect of the loan, such as: A. Any Acknowledgement of Debt. B. The cheque/s given by the Creditor to the Debtor in respect of the loan. C. Any cheque/s given by the Debtor to the Creditor in repayment of the loan. D. If a Promissory Note was received in payment of the loan, then it is necessary to lodge your claim on the proper Affidavit as mentioned in paragraph 4 above. 7. Should you not be able to attend the Meeting of Creditors, you may return the Power of Attorney omitting the name of the agent, and arrangements will be made for a responsible person to represent you at the Meeting. 8. The claim must be for the amount owing at the date of Business Rescue Proceedings commencing and where interest is claimed, it must be calculated to that date. 9. Claims for legal costs should be taxed.
BUSINESS RESCUE PROCEEDINGS: CLAIM FORM AFFIDAVIT for the proof of a claim In the MATTER OF: JINDAL MINING SA (PTY) LTD Creditor s name in full: Creditor s PHYSICAL address in full: Creditor s POSTAL address in full: Tel No: Email address: TOTAL AMOUNT OF CLAIM: R I, In my capacity as declare under oath: 1. THAT JINDAL MINING SA (PTY) LTD which Company/Corporation is in business rescue, was at the date of commencement of business rescue proceedings and still is indebted to: (name of creditor) 2. in the sum of (in words) THAT the said debt arose in the manner and at the time set forth in the account hereunto annexed. 3. THAT no other person besides the said COMPANY/CORPORATION is/are liable (otherwise then as surety) of the said debt or any part thereof THAT the said CREDITOR has not, nor has any other person, to my/our behalf received any security for the said debt or any part thereof save and except. (Insert here insert nature, particulars and value of Mortgage, pledge or other security) 4. That the claim was not acquired by cession after the institution of the proceedings by which the Company/Corporation was placed into business rescue. 5. That the facts stated herein are to my personal knowledge correct. SIGNATURE OF DECLARANT I certify the deponent has acknowledge that he knows and understands the contents of the aforegoing affidavit which was sworn to and signed before me at the day, of 20 on Regulations contained in Government Notice No. R1648 of the 19 th August 1977, having been complied with. PLEASE ENSURE THAT THE COMMISSIONER OF OATHS INSERTS HIS NAME IN FULL. COMMISSIONER OF OATHS Area for which appointment is held:
POWER OF ATTORNEY TO PROVE CLAIMS I/We, the undersigned Do hereby nominate, constitute and appoint: Jointly and severally, with Power of Substitution to be my/our lawful Attorney/s and Agent/s in my/our name, place and stead, to appear before the Master of the Supreme Court, or before any Magistrate, or before any Presiding Officer, at his or her office, likewise before any Commissioner, and to appear at all meetings of Creditors to be held in the matter of: JINDAL MINING SA (PTY) LTD and then and there as me/our act and deed to prove and file my/our claim of claims against the Estate of the Company/Corporation under Business Rescue, and generally for affecting the purposes aforesaid, to do or cause to be done whatsoever shall be requisite, as fully and effectually to all intents and purposes as I/We might or could do if personally present and acting herein, hereby ratifying, allowing and confirming and promising and Agreeing to ratify, allow and confirm all and whatsoever my/our said Attorney/s and Agent/s shall lawfully do or cause to be done in the premises by virtue of these presents. Give under my/our hand at this day of 20 in the presence of the undersigned witnesses For: (PTY) LIMITED/CLOSE CORPORATION AS WITNESSES: Witness: Witness:
(The Company/Corporation ) CERTIFIED COPY OF AN EXTRACT FROM THE MINUTES OF A MEETING OF DIRECTORS / MEMBERS OF THE ABOVE COMPANY / CORPORATION, HELD AT ON THE DAY OF 20 IT WAS RESOLVED THAT a Director / Member / Secretary / Accountant, of the Company / Corporation, be and is hereby authorised and empowered to sign all the necessary documents to enable the Company / Corporation to prove its claim against, to attend Meetings of Creditors of the vote on behalf of the Company / Corporation, with power in his discretion to substitute and appoint any other person or persons to attend such meetings on the Company s / Corporation s behalf to vote thereat. CERTIFIED A TRUE COPY SECRETARY
STATEMENT OF ACCOUNT In the case of the claim being in respect of goods sold/services rendered and delivered/provided on an open account, this statement should be completed in every respect and attached to your claim document NAME AND POSTAL ADDRESS OF CREDITOR: BRIEF DESCRIPTION OF GOODS/SERVICES SUPPLIED: A: DETAILS OF SALES DATE INVOICE NO. AMOUNT MONTHLY TOTALS (Not Progressive) TOTAL DEBITS A R
B: DETAILS OF PAYMENTS AND CREDITS ALLOWED DATE AMOUNT OF PAYMENT CREDIT (Specify) AMOUNT OF CREDIT MONTHLY TOTALS (Not Progressive) TOTAL CREDITS B R AMOUNT OF CLAIMS AS PER AFFIDAVIT I.E. A LESS B : NOTES: 1. If no payments were received, or credits given, state NIL under B. 2. A and B must reflect full period of trading or for period before the date of commencement of Business Rescue, namely 12 June 2018. 3. A brief description of the goods sold must be given 4. If insufficient space is provided above, the information required should be set out in a separate schedule and only the totals of A and B inserted on this statement.