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Case 1304677JKC11 Claim 141 Filed 06/06/13 Pg 1 of 2 B10 (Official Form 10) (12/12) UNITED STATES BANKRUPTCY COURT Southern District of Indiana Name of Debtor: Complete Hydraulic Service sales, Inc.

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What is claim no 14?

Claim no 14 is a form used to request compensation or benefits from an insurance company or other entity.

Who is required to file claim no 14?

Any individual or entity that has incurred a loss or damage covered by an insurance policy or agreement is required to file claim no 14.

How to fill out claim no 14?

Claim no 14 can be filled out by providing detailed information about the loss or damage, including the cause, date, and estimated value of the loss.

What is the purpose of claim no 14?

The purpose of claim no 14 is to formally request compensation or benefits for a covered loss or damage.

What information must be reported on claim no 14?

Information such as the policyholder's name, contact information, policy number, details of the loss, and any relevant supporting documentation must be reported on claim no 14.

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