HomeMy WebLinkAboutProof of Claims FormsUNITED STATES BANKRUPTCY COURT
UTHERN DISTRICT OF FlOnRIDA
PROOF OF CLAIM 9
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Chapter 11
GENERAL DEVELOPMENT CORPORATION Case N.S. 90.12231-BKC-AJC through
c/o LI,S Bankruptcy Court 90.12236-BKC-AJC Inclusive
P.O. BOX 013391 and 90.12337-BKC-AJC through
90.12339-BKC-AJC Inclusive
Miami, Florida 33101
PLEASE READ THE INSTRUCTIONS ON THE REVERSE SIDE CAREFULLY BEFORE FILLING OUT THIS PROOF OF CLAIM
DEBTOR: GENERAL DEVELOPMENT CORPORATION ( GDC') 90.12231-BKC-AJC
CREDITOR INFORMATION
(The creditor Is the person or other entity to whom the debtors owe money or property)
Name and Address of Creditor 9012231-0300762-00
CITY OF SEBASTIAN
PO BOX 780127
SEBASTIAN FL 32978
It name or address, as printed Is not
correct please Indicate correct name and
address to which checks and notices
should be delivered
Check here if this claim.
replaces a previously flied claim dated:
amends a previously filed claim dated:
supplements a previously filed claim dated:
the amount of claim you previously filed: (If any):
BASIS FOR CLAIM
Check box and attach copy of
assignment If claim has been assigned
to you.
C. CLAIM INFORMATION
CONTRACT FOR PURCHASE OF HOME
BONDS and/or DEBENTURES
CONTRACT FOR PURCHASE OF LAND
(principal. and Interest)
GOODS SOLD AND/OR SERVICES
STOCKS and/or STOCK WARRANTS
PERFORMED
WAGES/BENEFITS
MONIES LOANED
OTHER (DESCRIBE BRIEFLY)
PERSONAL INJURY/WRONGFUL DEATH/
PROPERTY DAMAGE
TAXES (Describe Briefly)
Type of Tax
Taxable Period
DATE DEBT WAS INCURRED:
In re:
General Development Corporation (GOC)
General Development Financial Services, Inc.
General Development Resorts, Inc.
Florida Residential Communities, Inc.
Five Star Homes Group, Inc.
GDV Financial Corporation
Environmental Quality Laboratory, Inc.
Five Star Homes, Inc.
Florida Home Finders, Inc.
Debtors.
Your claim is scheduled b the Debtor as:
Executory Fontract
Disputed
(In U.S. Dollars)
Unsecured
If there Is an amount shown, you have a claim
scheduled as shown. If the following appears:
EXECUTORY CONTRACT then you do not
have a scheduled claim. If BONDHOLDER',
STOCKHOLDER or BONDHOLDER/
STOCKHOLDER' appears, you are or were a
holder of Bonds, Debentures, Stocks or Stock
warrants with no scheduled aatm other than
for principal and/or Interest or equity.lf you
acres with the amount scheduled by the
debtor or you have already filed your claim
you do not need to file this proof of claim
The amount of claim you previously filed (if any):
If you have checked STOCKS and/or STOCK
WARRANTS, PLEASE BE ADVISED THAT THE
LIST OF SHAREHOLDERS FILED BY THE
DEBTORS CONSTITUTES PRIMA FACIE
EVIDENCE OF THE VALIDITY AND AMOUNT OF
THOSE SHAREHOLDERS' INTEREST AND IT
SHALL NOT BE NECESSARY FOR THEM TO FILE
A PROOF OF INTEREST.
If you have checked BONDS and/or
DEBENTURES, you may not need to file
this Proof of Claim for principal
and/or Interest due under such
BONDS/DEBENTURES. Seo Note 1 on
the reverse side of this form.
3. CLASSIFICATION OF CLAIM: Under the Bankruptcy Code all claims are classified as one or more of the following: (1) Priority, (2) Secured, (3) All Other Claims. Classify the nature of the claim
by CHECKING THE APPROPRIATE BOX OR BOXES which you believe best describes the' claim.
STATE THE AMOUNT OF THE CLAIM IN U.S. DOLLARS.
Al PRIORITY CLAIM S
You have a priority claim If any of the following
ARMY;
Wages, salaries or commissions (up to S2000),
earned within 90 days before filing of the
bankruptcy petition - 11 U.S.C. §507 (a)(3)
Contributions to an employee benefit plan (up to
S2.000. less amounts claimed under Section
507(a)(3) above) - 11 U.S.C. §507(a)(4)
Up to 5900 of deposits toward purchase, lease, or
rental of property or ser,ices for personal, family
or household use - 11 U.S.C. §507(a)(6)
Taxes or penalties of governmental units - 11 U.S.C.
§507(a)(7)
Other (specify under Section 507 for Priority treatment):
A2 SECURED CLAIM S
Attach evidence of perfection of security
Brief Description of Collateral :
Real Estate Motor Vehlcle Other
A3 ALL OTHER CLAIMS S
For the purposes of this form, a claim is ALL OTHER If
there Is no collateral, or to the extent the value of
collateral Is less than the amount of the debt, or If
It does not qualify as an Al priority claim under Section
507 of the Bankruptcy Code.
4. TOTAL AMOUNT OF CLAIM IN U.S. DOLLARS: S — S _ S - S
(Priority) (Secured) (Unsecured) (Total)
5. Attach copies of documents In support of this claim, such as purchase orders, Invoices, Itemized statements of running accounts, contracts, court judgments, or evidence of security Interest. If the
documents are not available, explain. If the documents are voluminous, attach a summary.
8. This form should 04I be used to make a claim for expenses Incurred of K the filing of the bankruptcy petition. Such expense maybe paid only upon proper application and notice pursuant to 1 1
U.S.C. §503.
7. CREDITS AND SETOFFS: Attach an Itemization of all amounts and dates of payments which have been credited against the debt. Set forth any setoff or counterclaim which the debtor may have
against your claim.
8. To receive an acknowledgment of the receipt of your claim, enclose a stamped, self-addressed envelope and a copy of your claim.
D. CERTIFICATION
The undersigned certifies under penalty of perjury that the debtor named above Is Indebted to the claimant In the amount shown, that there Is no security for
the debt other than that stated above or In an attachment to this form, that no unmatured Interest Is Included, and that the undersigned Is authorized to make this claim.
Date, Sign and Print the Name and Title, If any, of the Creditor or Other Person Authorized to File this Claim.
Please mall this form to GDC at the address set forth above. All claims must be received by December 10, 1990.
Penalty for Presenting Fraudulent Claim: Fine up to $5,000 or Imprisonment for up to 5 years, or both. Title 18, U.S.C. §152 and §3571.
UNITED STATES BANKRUPTCY COURT
WTHERN DISTRICT OF FLORIDA
PROOF OF CLAIM
Chapter 11
GENERAL DEVELOPMENT CORPORATION Case Nos. 90.12231-BKC-AJC through
c/o U.S Bankruptcy Court 90.12238-BKC-AJC inclusive
P.O. Box 013391 and 90.12337-BKC-AJC through
90.12339-BKC-AJC Inclusive
Miami, Florida 33101
PLEASE READ THE INSTRUCTIONS ON THE REVERSE SIDE CAREFULLY BEFORE FILLING OUT THIS PROOF OF CLAIM
DEBTOR: GENERAL DEVELOPMENT CORPORATION ( GDC') 90.12231-BKC-AJC
CREDITOR INFORMATION
(The creditor Is the person or other entity to whom the debtors owe money or property)
Name and Address of Creditor 9012231-0301078-00
CITY OF SEBASTIAN
PO BOX 780127
SEBASTIAN FL 32978
If name or address, as printed Is not
correct please Indicate correct name and
address to which checks and notices
should be delivered
Check here If this claim.
replaces a previously filed claim dated:
amends a previously filed claim dated:
supplements a previously filed claim dated:
the amount of claim you previously filed: (If any):
BASIS FOR CLAIM
Check box and attach copy of
assignment If claim has been assigned
to you.
C. CLAIM INFORMATION
CONTRACT FOR PURCHASE OF HOME
BONDS and/or DEBENTURES
CONTRACT FOR PURCHASE OF LAND
(principal and Interest)
GOODS SOLD AND/OR SERVICES
STOCKS and/or STOCK WARRANTS
PERFORMED
WAGES/BENEFITS
MONIES LOANED
OTHER (DESCRIBE BRIEFLY)
PERSONAL INJURY/WRONGFUL DEATH/
PROPERTY DAMAGE
TAXES (Describe Briefly)
Type of Tax
Taxable Period
DATE DEBT WAS INCURRED:
In re:
General Development Corporation ( GOC)
General Development Financial Services, Inc.
General Development Resorts, Inc.
Florida Residential Communtties, Inc.
Five Star Homes Group, Inc.
GOV Financial Corporation
Environmental Quality Laboratory, Inc.
Five Star Homes, Inc.
Florida Home Finders, Inc.
Debtors.
Your claim Is scheduled by the Debtor as:
zero dollars
Disputed
(In U.S. Dollars)
Unsecured
If there is an amount shown, you have a claim
scheduled as shown. If the following appears:
EXECUTORY CONTRACT, than you do not
have a scheduled claim. If BONDHOLDER,
STOCKHOLDER or BONDHOLDER/
STOCKHOLDERappears, you are or were a
holder of Bonds, Debentures, Stocks or Stock
Warrants with no scheduled claim other than
for principal and/or Interest or equity.lf you
aaree with the amount scheduled by the
debtor or you have already filed your claim
you do not need to file this proof of claim
The amount of claim you previously filed (if any):
If you have checked STOCKS and/or STOCK
WARRANTS, PLEASE BE ADVISED THAT THE
LIST OF SHAREHOLDERS FILED BY THE
DEBTORS CONSTITUTES PRIMA FACIE
EVIDENCE OF THE VALIDITY AND AMOUNT OF
THOSE SHAREHOLDERS' INTEREST AND IT
SHALL NOT BE NECESSARY FOR THEM TO FILE
A PROOF OF INTEREST.
If you have checked BONDS and/or
DEBENTURES, you may not need to file
this Proof of Claim for principal
and/or Interest due under such
BONDS/DEBENTURES. See Note 1 on
the reverse side of this form.
3. CLASSIFICATION OF CLAIM: Under the Bankruptcy Code all claims are classified as one or more of the following: (1) Priority, (2) Secured, (3) All Other Claims. Classify the nature of the claim
by CHECKING THE APPROPRIATE BOX OR BOXES which you believe best describes the claim.
STATE THE AMOUNT OF THE CLAIM IN U.S. DOLLARS.
Al PRIORITY CLAIM S
You have a priority claim If any of the following
AM211C
Wages, salaries or commissions (up to S2000),
earned within 90 days before filing of the
bankruptcy petition - 11 U.S.C. §507 (a) (3)
Contributions to an employee benefit plan (up to
52,000, lest amounts claimed under Section
507(a)(3) above) - 11 U.S.C. §507(a)(4)
Up to 5900 of deposits toward purchase, lease, or
rental of property or services for personal, family
or household use - 11 U.S.C. §507(a)(8)
Taxes or penalties of governmental units - 11 U.S.C.
§507(a)(7)
___ Other (specify under Section 507 for Priority treatment):
A2 SECURED CLAIM S
Attach evidence of perfection of security
Brief Description of Collateral :
Real Estate MotorVehicls Other
A3 ALL OTHER CLAIMS S
For the purposes of this form, a claim Is ALL OTHER If
there In no cnlletereL or to the extent the velu+ of
collateral Is less than the amount of the debt, or If
It does not qualify as an Al priority claim under Section
507 of the Bankruptcy Code.
4. TOTAL AMOUNT OF CLAIM IN U.S. DOLLARS: S S + S — S
(Priority) (Secured) (Unsecured) (Total)
5. Attach copies of documents In support of this claim, such as purchase orders, invoices, Itemized statements of running accounts, contracts, court judgments, or evidence of security Interest. If the
documents are not available, explain. If the documents are voluminous, attach a summary.
8. This form should = be used to make a claim for expenses Incurred jili filing of the bankruptcy petition. Such expense may be paid only upon proper application and notice pursuant to 11
U.S.C. §503.
7. CREDITS AND SETOFFS: Attach an Itemization of ail amounts and dates of payments which have been credited against the debt. Set forth any setoff or counterclaim which the debtor may have
against your claim.
8. To receive an acknowledgment of the receipt of your claim, enclose a stamped, self-addressed envelope and a copy of your claim.
D. CERTIFICATION
The undersigned certifies under penalty of perjury that the debtor named above Is Indebted to the claimant In the amount shown, that there Is no security for
the debt other than that stated above or In an attachment to this form, that no unmatured Interest Is Included, and that the undersigned Is authorized to make this claim.
Date, Sign and Print the Name and Title, If any, of the Creditor or Other Person Authorized to File this Claim.
Please mall this form to GDC at the address set forth above. All claims must be received by December 10, 1990.
Penalty for Presenting Fraudulent Claim: Fine up to S5,000 or Imprisonment for up to 5 years, or both, Title 18, U.S.C. §152 and §3571.
ISSTRULTION3_FC— COMPLETING PROOF OF CLAIM
• If you agree with the amount scheduled by the Debtor and have no other claims against
the Debtor, or you have already filed a proof of. claim, YOU DO NOT NEED TO FILE THIS
PROOF OF CLAItI,
• If you have any questions regarding the Proof of Claim form, please consult your
attorney.
A. DEBTOR INFORMATION. Your Proof of Claim identifies the Debtor against which your claim is believed
to run. If you hold a rlaim rgai.nst a different Debtor please correct. Section A by writing in the correct name.
DO NOT FILE. A PROOF OF CLAIM IF YOU DO NOT HAVE A CLAIM AGAINST ONE OF THE DEBTORS.
Th,t fillug of a al•gLe proof of claim against joint drbtors may render your claim ob,jectionab" and
ultJ• il,ely �,nrnforceable. f you believe more than one Debtor is liable to you on the same debt., yo,t MIDST file
A separate claim against enah such Debtor.
B. CREDITOR INFORMATION
Check your name and addre,s as print.nd to en+ure it is correct. If. that information is incorrect
please indicate the correct neme and/or address. Please chock the bottom box to the rightof, your name only
If you acquired your claim by assignment from a third party, and if so, please attach a copy of the assignment.
G AND THE PRMF OF
Please indicate by checking the appropriate box below your name, whether your Proof of Claim replaces,
amends, or supplements previously filed Proofs of Claim.
C. CLAIM INFORMATION
Number 1. Under number 1 you will chock the box that best desrrihes the reason why the Debtor owes
you money.
Pursuant to Bankruptcy Rule 3003(c)(5), the Indenture Trustees for the holders of General
Development Corporation 12-5/B% Subordinated Debentures due September 1, 2005 and 12-7/9% Senior
Subordinated Debentures due August 1, 1.995 will file class proofs of claim for any principal
and interest due to all kno-n and unknown holders of such Debentures. Accordingly, it shall
Number 2. This item requires you to indicate, to the beat of your ability, the month, day and year
the debt (claim) was incurred.
Number 3. This section requires you to classify your claim as either A(l), a priority claim; A(2),
a secured claim; or A(3), all other claims. Within the blank line you must indicate the amount of money owed
to you in ll _S. dollars. If you selected A(1) you must also check an additional box located under that category
that best describes the type of claim. IF YOU ARE NOT SURE HOW TO CLASSIFY YOUR CLAIM YOU SHOULD CONSULT AN
ATTORNEY.
IMPORTANT: You should select A(2) only if you bold collateral for your claim. If you received security
you will need to provide a very brief description of the property serving as collateral, attach a copy of the
documents evidencing that security interest and proof of perfection.
Number 4. SimpLy take the information you provided in Numbor 3 above indicating the amount owed in
U.S. dollars and totalling that amount in the far right area.
Number 5. YOU MAST ATTACH SUPPORTING DOCUMENTATION, HOWEVER, DO NOT ATTACH ORIGINAL DOCUMENTS. PLEASE
ATTACH COPIES ONLY.
Number 6. The Proof of Claim form should only bo used by you for a claim that was owed prior to April
6, 1990 (or prior to April 12, 1990 for the last three Debtors named in the upper right hand corner of the proof
of claim form).
Number 7. Do nothing unless there has been a setoff. If so, explain the setoff and indicate that it
has already been subtracted from the balance due you in Sections 3 and 4 above.
Number e. To receive an acknowledgment of the receipt of yo-rr claim, enclose a stamped, self-addressed
envelope and a copy of your claim.
D. CERTIFICATION
Upon completion of this claim form, you are certifying that this statement is true. Be sure to date
the claim form and place original signature of the claimant or person making the claim for the creditor where
Indicated at the bottom of the claim form. Please type or print name of individual under the signature.
IMPORTANT: You must mail this Proof of Claim such that it in received on or before December 10,
1990 to GENERAL DEVELOPMENT CORPORATION, c/o U.S. Bankruptcy Court, P.O. Box 013391, Miami, Florida 33101,
U.S.A.,