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UNITED STATES BANKRUPTCY COURT EASTER ISTRICT OF CALIFORNIA IN RE : AFTER : 07 8704176 CASE NUMBER : 2-87-04176-0 CAL-FARM SUPPLY CO. 1601 EXPOSITION BLVD. SSN/ID: SACRAMENTO, CA 95815-5103 94-1728957 PROOF OF CLAIM 1. This proof is made for the claimant named below by the undersigned individual who resides at and who also states that he or she is duly authorized to make this claim on behalf of the claimant, which Is AN INDIVIDUAL 13 A PARTNERSHIP 13A CORPORATION 13 OTHER (INDICATE THE STATE OF INCORPORATION, NAME OF PARTNERS, OR SUCH OTHER DESCRIPTION OF THE CLAIMANT AS MAY BE APPROPRIATE) 2. The past office address of the claimant and the address to which all notices to this claimant should be addressed is If name or address, as printed, iS not correct please indicate correct name and address to which cheeks end notices should be delivered. 8704176 — TRUSTEE WHIH CHARLES R. WHITWORTH POB 180 WEST SACRAMENTO, CA 95691 3. The debtor was, at the time of the filing of the petition initiating this case, and still is indebted (or liable) to this claimant, (excluding all unmetured interest) in the sum of----------------• ------_---.- $ 4. The consideration for this debt (or ground of liability) is as follows S. (If the claim is founded on writing) The writing on which this claim is founded (or a duplicate thereof) Is attached hereto for cannot be attached for the reason set forth in the statement attached hereto). 6. Of appropriate) This claim is founded on an open account which become for will become) due on as shown by the Itemized statement attached hereto. Unless It is attached hereto or its absence is explained in an attached statement, no note or other negotiable Instrument has been received for the account or any part of It. 7. No judgment has been rendered on this claim except 8. The amount of off payments on this claim has been credited and deducted for the purpose of making this proof of claim. 8. This claim is not subject to any set-off or counter-claim except 10. No security Interest Is held for this claim except (if security Interest in property of the debtor is claimed). The security Interest is claimed under the writing referred to In Paragraph 5 hereof (or unde a separate writing which (or a duplicate of which) is attached hereto, or under a separate writing which cannot be attached hereto for the reason set forth in the statement attached hereto). Evidence of perfection of such security Interest is also attached hereto. 11. This claim is a general unsecured claim, except to the extent that the security Interest, if any, described In paragraph 10 is sufficient to satisfy the claim. lit priority is claimed, state the amount and the basis thereof.) 12. If this claim is for salaries, wages, commissions or employee benefits entitled to priority as permitted by 45071a)(3) andlor 5507(a)(4) of the Bankruptcy Code, indicate the dates and the nature of the services performed, the rates Of compensation and claimant's Social Security Number. SSN INTERIM TRUSTEE — CHARLES R . WHITWORTH, POB 180 916-446-1618 WEST SACRAMENTO, CA 95691 FILE IN DUPLICATE WITH: DATED U. S . BANKRUPTCY COURT 650 CAPITOL MALL ROOM 8038 SIGNED SACRAMENTO, CA 95814-4708 (Name of individual, agent, officer or g partner signing this claim) PENALTY FOR PRESENTING FRAUDULENT CLAIM FINE OF NOT MORE THAN 15000 OR IMPRISONMENT FOR NOT MORE THAN 5 FORM 15 (8183) YEARS OR BOTH --TITLE 18. V.S.C. PAR 152.