SEC v. Global Finance & Investments, et. al.
Non-Investor Proof of Claim Form
On July 18, 2007, the United States Securities and Exchange Commission (the “SEC”) filed a lawsuit in federal court in Sherman, Texas against the following individuals and entities: Global Finance & Investments, Inc.; Charles R. Davis; William F. Dippolito; Lucre Fund, LLC; JTA Enterprises, Inc.; William H. Clark; Level Par Investments, LLC; Kelly G. Rogers; Sterling Meridian, LLC; Ronald J. Linn; and Glenn Maske. In addition, the SEC named the following entities as Relief Defendants: USASSET & Funding Corp.; Nevada Sentry Service Corp.; Wells Ventures, LLC; Triquestra Management Corp.; and CMR Mgmt. Group, LLC. In connection with the SEC’s lawsuit, the court has appointed S. Gregory Hays as Receiver for defendants Global Finance & Investment, Inc.; Charles R. Davis; Lucre Fund, LLC; JTA Enterprises, Inc.; William H. Clark; and Sterling Meridian, LLC; and Relief Defendant, Wells Ventures, LLC., along with certain assets believed to be in the possession of the Relief Defendants (the “Receiver Entities”). INSTRUCTIONS: If you are a non-investor creditor of any of the above listed Receiver Entities, it is necessary for you to file a claim with the Receiver. Accordingly, please complete all sections of this form. In order for your claim to be considered, you must provide copies of all supporting documents such as purchase orders, invoices, itemized statements of running accounts, contracts, court judgments, mortgages, security agreements and evidence of perfection of lien. The information provided should be complete and accurate. If you invested funds with any of the defendants, please use the Investor Proof of Claim Form located on the Receiver’s website at www.haysconsulting.net/globalfinance.html. Once completed, please return this form and related materials to the Receiver’s office addressed as follows: Global Finance Claims Hays Financial Consulting, LLC 3343 Peachtree Road, NE, Suite 200 Atlanta, Georgia 30326-1420 IMPORTANT NOTE: IF YOU DO NOT FILE THIS FORM AND THE SUPPORTING DOCUMENTS BY October 15, 2008, THE RECEIVER MAY NOT CONSIDER YOUR CLAIM IN DETERMINING HOW THE ASSETS OF THE RECEIVER ESTATE, IF ANY, ARE TO BE DISTRIBUTED. If your address changes after you submit this form, promptly advise the Receiver’s office of your new address. CLAIM INFORMATION 1. Claimant Information: ______________________________________________________ ______________________________________________________ ______________________________________________________ ______________________________________________________ ______________________________________________________ ______________________________________________________
Name or Company Name: Contact Person: Tax ID or SSN: Full Postal Address:
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Email: Phone Number (Home): Phone Number (Work): 2.
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The undersigned Claimant holds a claim in the amount of $____________ against the following Receiver Entities(s) (if you hold claims against more than one of the following, please identify the amounts owed by each on a separate piece of paper) for monies you claimed to be owed to you: Global Finance & Investments, Inc Charles R. Davis, Individually Lucre Fund, LLC JTA Enterprises, Inc William H. Clark, Individually Sterling Meridian, LLC Wells Ventures, LLC Other (Please identify): ______________________________________
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The basis for this claim is as follows (Check all that apply and provide ANY explanation on a separate piece of paper): Services performed Goods sold Wages and compensation Taxes Money loaned Severance Other _________________________
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Date(s) on which Claim Arose: In making this claim, Claimant hereby affirms, under penalty of perjury*: a. b. That the amounts claimed herein are true and correct; The claim amount set forth above is the net amount owed after crediting all offsets, credits and payments received by the undersigned.
THIS _____ DAY OF __________________, 2008.
Signature: Print Name: Title (if Corporation):
* Penalty for presenting fraudulent claim or providing false information: Fine of up to $ 50,000 or imprisonment for up to 5 years, or both 18 U.S.C.§ 152.
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