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-1 -IV >" B 10 Official Form 10 10/05 WESTERN MISSOURI IrL i�rS 11,r PROOF OF CLAIM UNITED STATES BANKRUPTCY COURT DISTRICT OF Name of Debtor Case Number Interstate Brands Co. 04-45816 APR - 2 20o7 - NOTE: This form should not be used to make a claim for an administrative expense arising after the commence (fit of the case. A "request"for payment of an administrative expense may be filed pursuant to 11 U.S.C. 503. 1`��1i�� [ Name of Creditor(The person or other entity to whom the debtor ❑ Check box if you are aware that anyone i'hW,1 r?�Rt/ s owes money or property): claim relating to your claim. Attach copy of statement giving State of California and related agencies particulars. Name and address where notices should be sent: ❑ Check box if you have never received any notices from the See Attached Exhibit for notice list bankruptcy court in this case. ❑ Check box if the address differs from the address on the envelope THIS SPACE FOR O sent to you by the court. COURT USE ONLY Telephone number: Last four digits of account or other number by which creditor Check here ❑ replaces identifies debtor: if this claim ❑ amends a previously filed claim,dated: 1. Basis for Claim ❑ Personal injury/wrongful death ❑ Wages,salaries,and compensation(fill out ❑ Goods sold below) ❑ Taxes Last four digits of your SS#: ❑ Services performed Unpaid compensation for services performed ❑ Retiree benefits as defined in 1 I U.S.C.§1114(a) ❑ Money loaned d From to Other Enviromental Cleanup (date) (date) 2. Date debt was incurred: 07/01/1988 3. If court judgment,date obtained: 4. Classification of Claim. Check the appropriate box or boxes that best describe your claim and state the amount of the claim at the time the case was filed. See reverse side for important explanations. Secured Claim Unsecured Nonpriority Claim $ Unknown ❑ Check this box if your claim is secured by collateral(including a right of setoff). ❑Check this box if:a)there is no collateral or lien securing your claim,or b) your claim exceeds the value of the property securing it,or c)none or only part Brief Description of Collateral: of your claim is entitled to priority. ❑ Real Estate ❑ Other ❑ Motor Vehicle Unsecured Priority Claim Value of Collateral: $ ❑ Check this box if you have an unsecured claim,all or part of which is entitled to priority. Amount of arrearage and other charges at time case filed included in secured claim,if any: $ Amount entitled to priority $ Specify the priority of the claim: ❑ Up to$2,225*of deposits toward purchase,lease,or rental of property or services for personal,family,or household use-11 U.S.C.§507(a)(7). ❑ Domestic support obligations under 11 U.S.C.§507(a)(I)(A)or(a)(1)(B). ❑ Taxes or penalties owed to governmental units-I 1 U.S.C.§507(a)(8). ❑ Wages,salaries,or commissions(up to$10,000),*earned within 180 days before filing of the bankruptcy petition or cessation of the debtor's business, ❑ Other—Specify applicable paragraph of 11 U.S.C.§507(a)(---). whichever is earlier-I 1 U.S.C.§507(a)(4). *Amounts are subject to adjustment on 411/07 and every 3 years thereafter with ❑ Contributions to an employee benefit plan-1 I U.S.C.§507(a)(5). respect to cases commenced on or after the date of adjustment. 5. Total Amount of Claim at Time Case Filed: $ Unknown Unknown (unsecured) (secured) (priority) (total) ❑ Check this box if claim includes interest or other charges in addition to the principal amount of the claim. Attach itemized statement of all interest or additional charges. 6. Credits: The amount of all payments on this claim has been credited and deducted for the purpose of making this proof of claim. THIS SPACE IS FOR COURT USE ONLY 7. Supporting Documents: Attach copies ofsupporting documents,such as promissory notes,purchase orders,invoices,itemized statements of running accounts,contracts,courtjudgments,mortgages,security agreements,and evidence of perfection of lien. DO NOT SEND ORIGINAL DOCUMENTS. If the documents are not available,explain. If the documents are voluminous,attach a summary. 8. Date-Stamped Copy: To receive an acknowledgment of the filing of you ,enclosea , ]f-addressed envelope and copy of this proof of claim. Date Sign and print the name and title,if a editor or t per or' �e-th' (attach copy of power of attorney,if any): 03/27/2007 Greene Radovsky aloney Share & Hennig , LLP, Attys for Lorrie Greene Penaltyfor presenting fraudulent claim: Fine of up to$500,000 or imprisonment for up to 5 years,or both. 18 U.S.C.§§152 and 3571.