Special administration—Client asset statement of claim

The following Restructuring & Insolvency precedent provides comprehensive and up to date legal information covering:

  • Special administration—Client asset statement of claim

Special administration—Client asset statement of claim

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[company name]

Date of special administration [date]

Client’s details: [enter details]

Name: [enter name]

Client account number: [account number]

Address: [enter address]

Email address: [enter email address]

Gross amount due to client at date of special administration order: [amount]

Account numberOriginal currency of the claimValue of claim:
(a) in the original currency(b) in sterling (GBP), £
Amount of claim for voting purposes (sterling)
£

Note: There is no requirement to complete this form if you have already agreed your final statement or submitted a Final Statement Query Form.

Signature [signature]:

Name [in CAPITAL LETTERS]:

Date [date]:

Address of signatory (if not client) [address]:

Authority of signatory (if not client) [address]:

NOTES:

    1. 1

      You are a client of [company name] if you are a person for whom [company name] has undertaken to receive or hold client assets, including client money, whether or not on trust and whether or not that undertaking has been complied with pursuant to the definition of client set out in The Investment Bank Special Administration Regulations 2011, SI 2011/245.

    1. 2

      You may be a potential client money claimant if [company name] holds, or (possibly) should hold, client money on your behalf in accordance with the rules made by virtue of section 137B of the Financial Services and Markets Act 2000 (clients’ money).

    1. 3

      There is no requirement to complete this form if you have

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