Fair Entitlements Guarantee Recovery Program Funding Application

FAIR ENTITLEMENTS GUARANTEE RECOVERY PROGRAM – FUNDING APPLICATION

1.General

1.1Name and ACN of the company in liquidation(Company)

1.2Liquidator(s)

(a)Name(s)
(b)Postaladdress
(c)Emailaddress
(d)Telephonenumber
(e)Date(s) ofappointment

1.3Type of winding up (i.e. voluntary orcourt-ordered)

2.Asset and liability position of theCompany

2.1Asset position of theCompany

(a)Total assets of theCompany
(i)bookvalue
(ii)estimated realisablevalue
(iii)estimated value (if proposed actionnot
pursued) / $
$
$
(b) Cash at bank and cash on hand / $
(c)Other non-contingentassets
(i)bookvalue
(ii)estimated realisablevalue / $
$
(d)Contingentassets
(i)bookvalue
(ii)estimated realisablevalue / $
$

2.2Liability position of theCompany

(a)Total liabilities of theCompany
(i)bookvalue
(ii)estimatedvalue / $
$
(b)Creditors (non-priority andunsecured)
(i)claim value
(ii)admittedvalue / $
$
(c)Creditors(secured)
(i)claim value
(ii)admittedvalue / $
$
(d) Contingent liabilities – estimated value / $

2.3Please separately provide copies of the Company's accounts, report as to affairs (Form 507) or Presentation of accounts and statement (Form 524) most recently lodged withASIC.

3.Commonwealth - Department ofJobs and Small Business

3.1Is the Commonwealth a creditor of theCompany?

Yes

No

3.2Has the Commonwealth lodged a proof of debt in the liquidation of theCompany?

Yes

No

If so:

(a)What is the amount of the Commonwealth's proof ofdebt?

(b)Has the proof of debt been admitted for dividendpurpose?

Yes

No

(c)What is the amount for which the proof of debt has beenadmitted?

(d)What is the amount of the interim dividend (if any) that has been paid to date tothe Commonwealth in respect of its proof ofdebt?

(e)If the proposed action, the subject of this application, were not pursued, what is likely to be the total amount of dividend(s) (both past and future) that the Commonwealth will receive in respect of its proof of debt? When is the Commonwealth likely to receive its next payment of dividend ordividends?

(f)If the proposed action, the subject of this application, were pursued andsuccessful, what is likely to be the total amount of dividend(s) (both past and future) that the Commonwealth will receive in respect of its proof ofdebt?

4.Other prioritycreditors

4.1What is the total amount of payments made to date in respect of priority claims undersection 556 of the Corporations Act (other than the Commonwealth's claim)? Please provide a breakdown of those payments by reference to the subparagraphs in section 556(1) of the CorporationsAct.

4.2What is the total unpaid amount of priority claims under section 556 of the CorporationsAct (other than the Commonwealth's claim)? Please provide a breakdown of those claims by reference to the subparagraphs in section 556(1) of the CorporationsAct.

4.3What are the current charge-out rates of yourself and other staff as relevant tothe proposed action?

4.4What is the estimated amount of future costs and expenses that will be incurred in the winding up (excluding costs associated with the proposed action)? Please explain how those costs and expenses mightarise.

5.Existing litigation funding arrangements and recoveryproceedings

5.1Are there any existing funding or indemnity arrangements between yourself (as liquidator ofthe Company) and one or more creditors or other persons? If so, please identify the funder(s) or indemnifier(s) and provide details of thosearrangements.

5.2Are you (as liquidator of the Company) and/or the Company currently engaged in, or proposing to commence, any recovery proceedings or litigations other than the proposed action, the subject of this application? If so, please provide details of thoseproceedings.

6.Proposedaction

6.1Please identify the cause(s) of action to which this applicationrelates.

6.2Please identify the defendant(s) to those cause(s) ofaction.

6.3What is the total claim amount for each cause of action? Please providedetails.

6.4Please identify any relevant limitation period in respect of each cause of action of which you are aware.

6.5Please provide an outline (in a separate document) the particulars of the cause(s) of action, including, withoutlimitation:

(a)the facts and circumstances giving rise to theclaim(s);

(b)an evaluation of the merits of theclaim(s);

(c)an evaluation of the prospects of success;and

(d)any peculiarity or complexities associated with the claim(s), of which you areaware.

6.6Please provide a brief description (in a separate document) of the supporting evidence, including, withoutlimitation:

(a)evidence that is in your possession or custody or is otherwiseavailable;

(b)evidence, or relevant information and documents, which you are aware of, but which are not currently in your possession orcustody;

(c)any actions which you have taken for the purposes of gathering evidence;and

(d)any actions which you propose to take to obtain furtherevidence.

6.7Have you already obtained an advice on the prospects of success of the cause(s) ofaction?

Yes

No

6.8What is your estimate of the likely duration of the proposed action? Please provide sufficient information to explain yourestimate.

6.9What is your estimate of the total costs (including your professional fees and legal costs) that are likely to be incurred in connection with the proposed action (if it were pursued to judgment)? Please provide sufficient information to explain yourestimate.

6.10In this application, are you applying for funding from the Commonwealth in respect of the entire amount of the estimated total costs (identified in your answer to question 6.9 above)? If not, please specify the other intended source(s) of funding for the proposed action (including any assets of the Company which you intend to realise and apply towards funding the proposed action).

6.11Please provide details of any steps you have already taken to investigate and pursue the cause(s) of action (for example, has any letter of demand been issued or public examinations conducted?).

6.12Haveyoualreadyengagedsolicitor(s)and/orlegalcounselinrelationtotheproposedaction?If so, please provide their details and their hourly/dailyrates.

6.13Please provide details of the asset position of the defendant or defendant(s), to the extent that you are aware. If available, please also provide copies of any evidence of the defendants' asset position.

6.14If the defendant(s) to the proposed action are director(s) or officer(s) of the Company, please provide details of any known D&O insurance policy of which the defendant(s)/officer(s) are beneficiaries. If available, and subject to any confidentiality restrictions, please also provide copies of all relevant policydocuments.

6.15If the defendant(s) to the proposed action are director(s) or officer(s) of the Company, please provide details of any known indemnity arrangement whereby the Company agrees to indemnify the director(s)/officer(s) for liabilities incurred in their capacity as such and/or their legal costs and expenses. If available, please also provide copies of all relevant indemnitydocuments.

7.Otherinformation

7.1Please separately provide copiesof:

(a)an historical company extract in respect of the Company;and

(b)any reports prepared in respect of the Company, pursuant to sections 439A, 476or 533 of the CorporationsAct.

7.2Please provide any other information and supporting documents which may be relevant toyour application for litigationfunding.

8.Signature and declaration byliquidator

9.Submission

Once completed and signed, please submit this Funding Application Form (together with all annexures and supporting documents) to the Commonwealth Department of Jobs and Small Business by email to or by post to:

FEG Recovery Team

DepartmentofJobsandSmallBusiness

GPO Box 9880

CANBERRA ACT 2601

Updated: February 2018