INSTRUCTIONS: CONNECTICUT PROOF OF CLAIM (SURETY LIQUIDATION)

This article discusses a proof of claim form that was made available following the liquidation of the Connecticut Surety Corporation and related affiliates. This form was made available to file a claim against these businesses. Though the deadline to file this form was August 29, 2003, the form can still be found on the website of the government of Connecticut.

Connecticut Proof Of Claim (Surety Liquidation) Step 1: Enter the claimant name in the first blank box.

Connecticut Proof Of Claim (Surety Liquidation) Step 2: Enter the claimant address in the second blank box.

Connecticut Proof Of Claim (Surety Liquidation) Step 3: Enter the claimant telephone number in the third blank box.

Connecticut Proof Of Claim (Surety Liquidation) Step 4: Enter the claimant Social Security number or tax identification number in the fourth blank box.

Connecticut Proof Of Claim (Surety Liquidation) Step 5: Enter the total amount of the claim in the fifth blank box.

Connecticut Proof Of Claim (Surety Liquidation) Step 6: If any affiliates paid any portion of your claim, enter the name of the affiliate in the sixth blank box and the date of payment and the amount of payment made in the seventh blank box.

Connecticut Proof Of Claim (Surety Liquidation) Step 7: If you hold any security or collateral provided by the affiliates or claim a right of setoff against any of the affiliates, enter the name of the affiliates in question in the eighth blank box and the amount held or subject to set setoff in the ninth blank box.

Connecticut Proof Of Claim (Surety Liquidation) Step 8: If you assert any right of priority senior to the right of general creditors, identify the priority asserted and the basis for this assertion in the tenth blank box.

Connecticut Proof Of Claim (Surety Liquidation) Step 9: If you are represented by an attorney, enter their name in the eleventh blank box, their address in the twelfth blank box, and their telephone number in the thirteen blank box.

Connecticut Proof Of Claim (Surety Liquidation) Step 10: The claimant or individual, partner, officer or legal representative of the claimant should provide their signature, the date, their title or official capacity and telephone number where indicated.

Connecticut Proof Of Claim (Surety Liquidation) Step 11: A notary public should be presented with the form to affix their seal.