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In re Vyaire Medical — Statement of Financial Affairs (Vyaire Medical 205, Inc.)

Date
2024-07-09

Summary

The Statement of Financial Affairs for Vyaire Medical 205, Inc., Case No. 24-11232, filed July 9, 2024 as Doc 201 in the jointly administered Chapter 11 cases of Vyaire Medical, Inc., et al., Case No. 24-11217 (BLS), in the U.S. Bankruptcy Court for the District of Delaware. The 37-page form answers "None" to its questions on gross revenue, non-business revenue, payments to creditors within 90 days before filing, insider transfers within 1 year, setoffs, legal actions, gifts, losses and closed financial accounts. In Part 13 it lists VYAIRE HOLDING COMPANY as the parent corporation of a consolidated tax group. The Part 14 declaration was executed on July 8, 2024 by Charles N. Braley, Chief Restructuring Officer.

Summary drafted by a model from the document's text below and checked by script against that text before publication. It is a navigation aid, not a reading of what the document proves. Where AI is used

Full text

           Case 24-11217-BLS      Doc 201       Filed 07/09/24   Page 1 of 37




IN THE UNITED STATES BANKRUPTCY COURT FOR
THE DISTRICT OF DELAWARE

                                            )
In re                                       )   Chapter 11
                                            )
  VYAIRE MEDICAL, INC., et al.              )   Case No. 24-11217 (BLS)
                                            )
        Debtors.                            )   (Jointly Administered)
                                            )



                   STATEMENT OF FINANCIAL AFFAIRS FOR

                            Vyaire Medical 205, Inc.

                                 CASE NO. 24-11232
                           Case 24-11217-BLS        Doc 201      Filed 07/09/24   Page 2 of 37
Vyaire Medical 205, Inc.                                                                             Case Number: 24-11232


   Part 1:       Income



  1. Gross Revenue from business
               None.


    Identify the Beginning and Ending Dates of the Debtor's Fiscal Year,     Sources of Revenue           Gross
    which may be a Calendar Year                                            (Check all that apply)      Revenue
                                                                                                         (Before
                                                                                                       Deductions
                                                                                                           and
                                                                                                       Exclusions)
                           Case 24-11217-BLS                Doc 201        Filed 07/09/24          Page 3 of 37
Vyaire Medical 205, Inc.                                                                                                   Case Number: 24-11232


   Part 1:       Income



  2. Non-business revenue

      Include all guarantors and co-obligors. In Column 2, identify the creditor to whom the debt is owed and each schedule on which the
      creditor is listed. If the codebtor is liable on a debt to more than one creditor, list each creditor separately in Column 2.
               None.


                                                                                        Description of Sources of               Gross
                                                                                        Revenue                               Revenue
                                                                                                                               (Before
                                                                                                                             Deductions
                                                                                                                                 and
                                                                                                                             Exclusions)
                            Case 24-11217-BLS                 Doc 201        Filed 07/09/24           Page 4 of 37
Vyaire Medical 205, Inc.                                                                                                      Case Number: 24-11232


   Part 2:       List Certain Transfers Made Before Filing for Bankruptcy



  3. Certain payments or transfers to creditors within 90 days before filing this case

      List payments or transfers — including expense reimbursements — to any creditor, other than regular employee compensation, within
      90 days before filing this case unless the aggregate value of all property transferred to that creditor is less than $7,575. (This amount
      may be adjusted on 4/01/25 and every 3 years after that with respect to cases filed on or after the date of adjustment.)
               None.


    Creditor's Name and Address                                              Dates          Total Amount          Reasons for Payment or
                                                                                              or Value                  Transfer
                             Case 24-11217-BLS                 Doc 201          Filed 07/09/24           Page 5 of 37
Vyaire Medical 205, Inc.                                                                                                          Case Number: 24-11232


   Part 2:       List Certain Transfers Made Before Filing for Bankruptcy



  4. Payments or other transfers of property made within 1 year before filing this case that benefited any insider

      List payments or transfers, including expense reimbursements, made within 1 year before filing this case on debts owed to an insider or
      guaranteed or cosigned by an insider unless the aggregate value of all property transferred to or for the benefit of the insider is less than
      $7,575. (This amount may be adjusted on 4/01/25 and every 3 years after that with respect to cases filed on or after the date of
      adjustment.) Do not include any payments listed in line 3. Insiders include officers, directors, and anyone in control of a corporate debtor
      and their relatives; general partners of a partnership debtor and their relatives; affiliates of the debtor and insiders of such affiliates; and
      any managing agent of the debtor. 11 U.S.C. § 101(31).
               None.


    Insider's Name and Address and                                   Dates                Amount                    Reasons for Payment
    Relationship to Debtor
                             Case 24-11217-BLS                  Doc 201         Filed 07/09/24            Page 6 of 37
Vyaire Medical 205, Inc.                                                                                                           Case Number: 24-11232


   Part 2:       List Certain Transfers Made Before Filing for Bankruptcy



  5. Repossessions, foreclosures, and returns

      List all property of the debtor that was obtained by a creditor within 1 year before filing this case, including property repossessed by a
      creditor, sold at a foreclosure sale, transferred by a deed in lieu of foreclosure, or returned to the seller. Do not include property listed in
      line 6.
               None.


    Creditor's Name and Address                  Description of the property                            Date                   Value of Property
                             Case 24-11217-BLS                  Doc 201         Filed 07/09/24            Page 7 of 37
Vyaire Medical 205, Inc.                                                                                                           Case Number: 24-11232


   Part 2:       List Certain Transfers Made Before Filing for Bankruptcy



  6. Setoffs

      List any creditor, including a bank or financial institution, that within 90 days before filing this case set off or otherwise took anything from
      an account of the debtor without permission or refused to make a payment at the debtor's direction from an account of the debtor
      because the debtor owed a debt.
               None.


    Creditor's Name and Address                  Description of Action                    Date Action             Account               Amount
                                                 Creditor Took                              Taken                 Number
                            Case 24-11217-BLS                 Doc 201         Filed 07/09/24           Page 8 of 37
Vyaire Medical 205, Inc.                                                                                                       Case Number: 24-11232


   Part 3:       Legal Actions or Assignments



  7. Legal actions, administrative proceedings, court actions, executions, attachments, or governmental audits

      List the legal actions, proceedings, investigations, arbitrations, mediations, and audits by federal or state agencies in which the debtor
      was involved in any capacity—within 1 year before filing this case.
               None.


    Caption of Suit and Case                    Nature of Proceeding            Court or Agency and Address                  Status of Case
    Number
                            Case 24-11217-BLS                 Doc 201         Filed 07/09/24           Page 9 of 37
Vyaire Medical 205, Inc.                                                                                                       Case Number: 24-11232


   Part 3:       Legal Actions or Assignments



  8. Assignments and receivership

      List any property in the hands of an assignee for the benefit of creditors during the 120 days before filing this case and any property in
      the hands of a receiver, custodian, or other court-appointed officer within 1 year before filing this case.
               None.


    Custodian's Name and                   Court Name and              Case Title and           Date         Description of            Value
    Address                                   Address                    Number                                Property
                           Case 24-11217-BLS             Doc 201         Filed 07/09/24         Page 10 of 37
Vyaire Medical 205, Inc.                                                                                                Case Number: 24-11232


   Part 4:       Certain Gifts and Charitable Contributions



  9. List all gifts or charitable contributions the debtor gave to a recipient within 2 years before filing this case unless the
     aggregate value of the gifts to that recipient is less than $1,000
               None.


    Recipient's Name and Address               Recipient's               Description of the Gifts             Dates                Value
                                               Relation to Debtor        and Contributions                    Given
                           Case 24-11217-BLS                Doc 201           Filed 07/09/24               Page 11 of 37
Vyaire Medical 205, Inc.                                                                                                     Case Number: 24-11232


   Part 5:       Certain Losses



  10. All losses from fire, theft, or other casualty within 1 year before filing this case.
               None.


    Description of the property lost           Amount of Payments Received for the                            Date of Loss      Value of
    and how the lost occurred                  Loss                                                                           Property Lost
                                               If you have received payments to cover the loss, for
                                               example, from insurance, government compensation, or tort
                                               liability, list the total received.

                                               List unpaid claims on Official Form 106A/B (Schedule A/B:
                                               Assets - Real and Personal Property).
                           Case 24-11217-BLS                Doc 201         Filed 07/09/24          Page 12 of 37
Vyaire Medical 205, Inc.                                                                                                      Case Number: 24-11232


   Part 6:       Certain Payments or Transfers



  11. Payments related to bankruptcy

       List any payments of money or other transfers of property made by the debtor or person acting on behalf of the debtor within 1 year
       before the filing of this case to another person or entity, including attorneys, that the debtor consulted about debt consolidation or
       restructuring, seeking bankruptcy relief, or filing a bankruptcy case.
               None.


    Who was Paid or Who            Email / Website              Who Made            If not Money,                    Dates            Value
    Received the                                                the Payment,        Describe any
    Transfer? Address                                           if not Debtor       Property Transferred
                           Case 24-11217-BLS               Doc 201         Filed 07/09/24          Page 13 of 37
Vyaire Medical 205, Inc.                                                                                                    Case Number: 24-11232


   Part 6:       Certain Payments or Transfers



  12. Self-settled trusts of which the debtor is a beneficiary

       List any payments or transfers of property made by the debtor or a person acting on behalf of the debtor within 10 years before the
       filing of this case to a self-settled trust or similar device. Do not include transfers already listed on this statement.
               None.


    Name of Trust or Device                Trustee                  Describe any Property             Dates Transfers             Total
                                                                    Transfered                          Were Made                Amount /
                                                                                                                                  Value
                           Case 24-11217-BLS                 Doc 201         Filed 07/09/24           Page 14 of 37
Vyaire Medical 205, Inc.                                                                                                        Case Number: 24-11232


   Part 6:       Certain Payments or Transfers



  13. Transfers not already listed on this statement

       List any transfers of money or other property - by sale, trade, or any other means - made by the debtor or a person acting on behalf of
       the debtor within 2 years before the filing of this case to another person, other than property transferred in the ordinary course of
       business or financial affairs. Include both outright transfers and transfers made as security. Do not include gifts or transfers previously
       listed on this statement.
               None.


    Name and Address of Transferee,                            Description of Property                     Date Transfer          Total Amount
    Relationship to Debtor                                                                                  was Made                or Value
                           Case 24-11217-BLS               Doc 201         Filed 07/09/24          Page 15 of 37
Vyaire Medical 205, Inc.                                                                                                    Case Number: 24-11232


   Part 7:       Previous Locations



  14. Previous Addresses

       List all previous addresses used by the debtor within 3 years before filing this case and the dates the addresses were used.
               None.


    Address                                                                                                    Dates of Occupancy
                           Case 24-11217-BLS                 Doc 201         Filed 07/09/24           Page 16 of 37
Vyaire Medical 205, Inc.                                                                                                Case Number: 24-11232


   Part 8:       Health Care Bankruptcies



  15. Health Care bankruptcies

       Is the debtor primarily engaged in offering services and facilities for:
       - diagnosing or treating injury, deformity, or disease, or
       - providing any surgical, psychiatric, drug treatment, or obstetric care?
               None.


    Facility Name and Address                   Nature of the                 Location Where            If Debtor       How are
                                                Business                      Patient Records are       Provides        Records
                                                Operation,                    Maintained (if            Meals and       Kept?
                                                Including Type of             Different from            Housing,
                                                Services the Debtor           Facility Address). If     Number of
                                                Provides                      Electronic, Identify      Patients in
                                                                              any Service               Debtor's Care
                                                                              Provider
                           Case 24-11217-BLS                Doc 201     Filed 07/09/24       Page 17 of 37
Vyaire Medical 205, Inc.                                                                                     Case Number: 24-11232


   Part 9:       Personally Identifiable Information



  16. Does the debtor collect and retain personally identifiable information of customers?
     No
     Yes. State the nature of the information collected and retained.


     Does the debtor have a privacy policy about that information?
         No
         Yes
                              Case 24-11217-BLS          Doc 201      Filed 07/09/24        Page 18 of 37
Vyaire Medical 205, Inc.                                                                                            Case Number: 24-11232


   Part 9:         Personally Identifiable Information



  17. Within 6 years before filing this case, have any employees of the debtor been participants in any ERISA, 401(k), 403(b), or
      other pension or profit-sharing plan made available by the debtor as an employee benefit?
     No. Go to Part 10.
     Yes. Does the debtor serve as plan administrator?

         No. Go to Part 10.
         Yes

         Describe:                                                    EIN:

         Has the plan been terminated?
             No
             Yes
                           Case 24-11217-BLS                 Doc 201         Filed 07/09/24           Page 19 of 37
Vyaire Medical 205, Inc.                                                                                                       Case Number: 24-11232


   Part 10:      Certain Financial Accounts, Safe Deposit Boxes, and Storage Units



  18. Closed financial accounts

       Within 1 year before filing this case, were any financial accounts or instruments held in the debtor's name, or for the debtor's benefit,
       closed, sold, moved, or transferred?

       Include checking, savings, money market, or other financial accounts; certificates of deposit; and shares in banks, credit unions,
       brokerage houses, cooperatives, associations, and other financial institutions.
               None.


    Financial Institution Name and              Last 4 Digits         Type of Account                 Date of Closing            Last Balance
    Address                                     of Account
                                                Number
                           Case 24-11217-BLS                Doc 201         Filed 07/09/24          Page 20 of 37
Vyaire Medical 205, Inc.                                                                                                      Case Number: 24-11232


   Part 10:      Certain Financial Accounts, Safe Deposit Boxes, and Storage Units



  19. Safe deposit boxes

       List any safe deposit box or other depository for securities, cash, or other valuables the debtor now has or did have within 1 year
       before filing this case.
               None.


    Depository Institution Name and            Names of Anyone with Access                 Description of the                   Does Debtor
    Address                                    to it and Address                           Contents                             still have it?
                            Case 24-11217-BLS                 Doc 201         Filed 07/09/24            Page 21 of 37
Vyaire Medical 205, Inc.                                                                                                          Case Number: 24-11232


   Part 10:      Certain Financial Accounts, Safe Deposit Boxes, and Storage Units



  20. Off-premises storage

       List any property kept in storage units or warehouses within 1 year before filing this case. Do not include facilities that are in a part of a
       building in which the debtor does business.
               None.


    Facility Name and Address                    Names of                  Address                       Description of the            Does
                                                 Anyone with                                             Contents                      Debtor still
                                                 Access to it                                                                          have it?
                           Case 24-11217-BLS                Doc 201         Filed 07/09/24           Page 22 of 37
Vyaire Medical 205, Inc.                                                                                                      Case Number: 24-11232


   Part 11:      Property the Debtor Holds or Controls That the Debtor Does Not Own



  21. Property held for another

       List any property that the debtor holds or controls that another entity owns. Include any property borrowed from, being stored for, or
       held in trust. Do not list leased or rented property.
               None.


    Owner's Name and Address                           Location of the Property            Description of the                       Value
                                                                                           Property
                           Case 24-11217-BLS                 Doc 201         Filed 07/09/24           Page 23 of 37
Vyaire Medical 205, Inc.                                                                                                        Case Number: 24-11232


   Part 12:      Details About Environmental Information


  For the purpose of Part 12, the following definitions apply:
       Environmental law means any statute or governmental regulation that concerns pollution, contamination, or hazardous material,
       regardless of the medium affected (air, land, water, or any other medium)
       Site means any location, facility, or property, including disposal sites, that the debtor now owns, operates, or utilizes or that the debtor
       formerly owned, operated, or utilized.
       Hazardous material means anything that an environmental law defines as hazardous or toxic, or describes as a pollutant, contaminant,
       or a similarly harmful substance.
  Report all notices, releases, and proceedings known, regardless of when they occurred.

  22. Has the debtor been a party in any judicial or administrative proceeding under any environmental law? Include settlements
      and orders.
               None.


    Case Title and Case Number                  Court or Agency Name and                    Nature of Proceeding                      Status
                                                Address
                           Case 24-11217-BLS                 Doc 201         Filed 07/09/24           Page 24 of 37
Vyaire Medical 205, Inc.                                                                                                        Case Number: 24-11232


   Part 12:      Details About Environmental Information


  For the purpose of Part 12, the following definitions apply:
       Environmental law means any statute or governmental regulation that concerns pollution, contamination, or hazardous material,
       regardless of the medium affected (air, land, water, or any other medium)
       Site means any location, facility, or property, including disposal sites, that the debtor now owns, operates, or utilizes or that the debtor
       formerly owned, operated, or utilized.
       Hazardous material means anything that an environmental law defines as hazardous or toxic, or describes as a pollutant, contaminant,
       or a similarly harmful substance.
  Report all notices, releases, and proceedings known, regardless of when they occurred.

  23. Has any governmental unit otherwise notified the debtor that the debtor may be liable under or in violation of an
      environmental law?
               None.


    Site Name and Address                       Governmental Unit Name and                  Environmental Law, if                Date of Notice
                                                Address                                     Known
                            Case 24-11217-BLS                 Doc 201         Filed 07/09/24           Page 25 of 37
Vyaire Medical 205, Inc.                                                                                                         Case Number: 24-11232


   Part 12:      Details About Environmental Information


  For the purpose of Part 12, the following definitions apply:
       Environmental law means any statute or governmental regulation that concerns pollution, contamination, or hazardous material,
       regardless of the medium affected (air, land, water, or any other medium)
       Site means any location, facility, or property, including disposal sites, that the debtor now owns, operates, or utilizes or that the debtor
       formerly owned, operated, or utilized.
       Hazardous material means anything that an environmental law defines as hazardous or toxic, or describes as a pollutant, contaminant,
       or a similarly harmful substance.
  Report all notices, releases, and proceedings known, regardless of when they occurred.

  24. Has the debtor notified any governmental unit of any release of hazardous material?
               None.


    Site Name and Address                        Governmental Unit Name and                  Environmental Law, if                Date of Notice
                                                 Address                                     Known
                           Case 24-11217-BLS                Doc 201         Filed 07/09/24          Page 26 of 37
Vyaire Medical 205, Inc.                                                                                                     Case Number: 24-11232


   Part 13:      Details About the Debtor's Business or Connections to Any Business



  25. Other businesses in which the debtor has or has had an interest

       List any business for which the debtor was an owner, partner, member, or otherwise a person in control within 6 years before filing this
       case. Include this information even if already listed in the Schedules.
               None.


    Business Name and Address                  Describe the Nature of the                 Employer Identification                  Dates
                                               Business                                   Number (Do not include                 Business
                                                                                          SSN or ITIN)                            Existed
                           Case 24-11217-BLS               Doc 201        Filed 07/09/24          Page 27 of 37
Vyaire Medical 205, Inc.                                                                                                  Case Number: 24-11232


   Part 13:      Details About the Debtor's Business or Connections to Any Business



  26. Books, records, and financial statements

  26a. List all accountants and bookkeepers who maintained the debtor's books and records within 2 years before filing this case.
               None.


    Name and Address                                                                                            Dates of Service



   26a.1 CALEB MOORE                                                                                         05/01/2021 - 02/01/2023
         26125 N. RIVERWOODS BLVD.
           METTAWA, IL 60045

   26a.2 DEBRA LAMB MICHAUD                                                                                  02/01/2023 - 11/01/2023
           26125 N. RIVERWOODS BLVD.
           METTAWA, IL 60045

   26a.3 EDWARD MANLEY                                                                                       03/01/2024 - ONGOING
           26125 N. RIVERWOODS BLVD.
           METTAWA, IL 60045

   26a.4 KIRA BROWN                                                                                          11/01/2023 - 03/01/2024
           26125 N. RIVERWOODS BLVD.
           METTAWA, IL 60045

   26a.5 PHIL CUTTING                                                                                        12/01/2021 - 05/01/2023
           26125 N. RIVERWOODS BLVD.
           METTAWA, IL 60045

   26a.6 VIKRAM BAJAJ                                                                                        05/01/2023 - ONGOING
           26125 N. RIVERWOODS BLVD.
           METTAWA, IL 60045
                           Case 24-11217-BLS               Doc 201         Filed 07/09/24          Page 28 of 37
Vyaire Medical 205, Inc.                                                                                                    Case Number: 24-11232


   Part 13:      Details About the Debtor's Business or Connections to Any Business



  26. Books, records, and financial statements

  26b. List all firms or individuals who have audited, compiled, or reviewed debtor's books of account and records or prepared a financial
  statement within 2 years before filing this case.
               None.


    Name and Address                                                                                             Dates of Service



   26b.1 ERNST & YOUNG US LLP                                                                                       - ONGOING
         200 PLAZA DR, STE 2222
           SECAUCUS, NJ 07094-3607
                           Case 24-11217-BLS                Doc 201         Filed 07/09/24          Page 29 of 37
Vyaire Medical 205, Inc.                                                                                                      Case Number: 24-11232


   Part 13:      Details About the Debtor's Business or Connections to Any Business



  26. Books, records, and financial statements

  26c. List all firms or individuals who were in possession of the debtor's books of account and records when this case is filed.
               None.


    Name and Address                                                                         If any Books of Account and Records are
                                                                                                     Unavailable, Explain Why


   26c.1 EDWARD MANLEY
           26125 N. RIVERWOODS BLVD.
           METTAWA, IL 60045

   26c.2 VIKRAM BAJAJ
           26125 N. RIVERWOODS BLVD.
           METTAWA, IL 60045
                           Case 24-11217-BLS                 Doc 201         Filed 07/09/24           Page 30 of 37
Vyaire Medical 205, Inc.                                                                                                        Case Number: 24-11232


   Part 13:      Details About the Debtor's Business or Connections to Any Business



  26. Books, records, and financial statements

  26d. List all financial institutions, creditors, and other parties, including mercantile and trade agencies, to whom the debtor issued a financial
  statement within 2 years before filing this case.
               None.


    Name and Address



   26d.1 BANK OF AMERICA, N.A., AS ADMINISTRATIVE AGENT AND COLLATERAL AGENT
           135 S. LASALLE STREET
           IL4-135-09-61
           CHICAGO, IL 60603-4157

   26d.2 WILMINGTON TRUST, NATIONAL ASSOCIATION, AS COLLATERAL AGENT
           50 SOUTH SIXTH STREET
           SUITE 1290
           MINNEAPOLIS, MN 55402

   26d.3 WILMINGTON TRUST, NATIONAL ASSOCIATION, AS COLLATERAL AGENT
           1100 NORTH MARKET STREET
           WILMINGTON, DE 19890
                           Case 24-11217-BLS                Doc 201         Filed 07/09/24          Page 31 of 37
Vyaire Medical 205, Inc.                                                                                            Case Number: 24-11232


   Part 13:      Details About the Debtor's Business or Connections to Any Business



  27. Inventories

       Have any inventories of the debtor's property been taken within 2 years before filing this case?
               None.


    Name of the Person who              Name and Address of the                        Date of             Dollar        Basis
    Supervised the Taking of            Person who has Possession of                  Inventory           Amount
    the Inventory                       Inventory Records
                           Case 24-11217-BLS          Doc 201        Filed 07/09/24        Page 32 of 37
Vyaire Medical 205, Inc.                                                                                          Case Number: 24-11232


   Part 13:      Details About the Debtor's Business or Connections to Any Business



  28. List the debtor's officers, directors, managing members, general partners, members in control, controlling shareholders, or
      other people in control of the debtor at the time of the filing of this case.
               None.


    Name and Address                             Position and Nature of any Interest                  Percent of Interest, if any



   28.1 JUNE JOHNSON                            TREASURER
        ADDRESS ON FILE

   28.2 RACHEL LISENBY                          PRESIDENT AND SECRETARY
        ADDRESS ON FILE

   28.3 VIKRAM BAJAJ                            DIRECTOR, GROUP CFO
        ADDRESS ON FILE
                           Case 24-11217-BLS           Doc 201        Filed 07/09/24         Page 33 of 37
Vyaire Medical 205, Inc.                                                                                            Case Number: 24-11232


   Part 13:      Details About the Debtor's Business or Connections to Any Business



  29. Within 1 year before the filing of this case, did the debtor have officers, directors, managing members, general partners,
      members in control of the debtor, or shareholders in control of the debtor who no longer hold these positions?
               None.


    Name and Address                              Position and Nature of Interest                          Period During Which
                                                                                                            Position Was Held


   29.1 CALEB MOORE                              DIRECTOR AND OFFICER                                     09/30/2021 - 02/10/2023
        26125 N. RIVERWOODS BLVD.
         METTAWA, IL 60045

   29.2 DEBRA LAMB MICHAUD                       OFFICER                                                  02/13/2023 - 11/28/2023
         26125 N. RIVERWOODS BLVD.
         METTAWA, IL 60045

   29.3 JOHN BIBB                                DIRECTOR AND OFFICER                                     09/30/2021 - 11/28/2023
         26125 N. RIVERWOODS BLVD.
         METTAWA, IL 60045

   29.4 PHILIP CUTTING                           DIRECTOR AND OFFICER                                     01/14/2022 - 05/24/2023
         26125 N. RIVERWOODS BLVD.
         METTAWA, IL 60045
                           Case 24-11217-BLS                 Doc 201         Filed 07/09/24          Page 34 of 37
Vyaire Medical 205, Inc.                                                                                                       Case Number: 24-11232


   Part 13:      Details About the Debtor's Business or Connections to Any Business



  30. Payments, Distributions, or Withdrawals Credited or Given to Insiders

       Within 1 year before filing this case, did the debtor provide an insider with value in any form, including salary, other compensation,
       draws, bonuses, loans, credits on loans, stock redemptions, and options exercised?
               None.


    Name and Address of Recipient and                      Amount               Amount                  Dates                Reason for
    Relationship to Debtor                                                     Description                               Providing the Value
                           Case 24-11217-BLS          Doc 201       Filed 07/09/24        Page 35 of 37
Vyaire Medical 205, Inc.                                                                                         Case Number: 24-11232


   Part 13:      Details About the Debtor's Business or Connections to Any Business



  31. Within 6 years before filing this case, has the debtor been a member of any consolidated group for tax purposes?
               None.


    Name of Parent Corporation                                      Employer Identification Number of the Parent
                                                                    Corporation


   31.1 VYAIRE HOLDING COMPANY                                     36-4835388
                           Case 24-11217-BLS           Doc 201       Filed 07/09/24        Page 36 of 37
Vyaire Medical 205, Inc.                                                                                          Case Number: 24-11232


   Part 13:      Details About the Debtor's Business or Connections to Any Business



  32. Within 6 years before filing this case, has the debtor as an employer been responsible for contributing to a pension fund?
               None.


    Name of Pension Fund                                             Employer Identification Number of the Parent
                                                                     Corporation
                               Case 24-11217-BLS             Doc 201           Filed 07/09/24        Page 37 of 37
Vyaire Medical 205, Inc.                                                                                                        Case Number: 24-11232


   Part 14:      Signature and Declaration



  WARNING -- Bankruptcy fraud is a serious crime. Making a false statement, concealing property, or obtaining money or property by
  fraud in connection with a bankruptcy case can result in fines up to $500,000 or imprisonment for up to 20 years, or both. 18 U.S.C.
  §§ 152, 1341, 1519, and 3571.

  I have examined the information in this Statement of Financial Affairs and any attachments and have a reasonable belief that the
  information is true and correct.

  I declare under penalty of perjury that the foregoing is true and correct.



  Executed on:             07/08/2024


  Signature:               /s/ Charles N. Braley                               Charles N. Braley, Chief Restructuring Officer
                                                                               Name and Title


  Are additional pages to the Statement of Financial Affairs for Non-Individuals Filing for Bankruptcy (Official Form 207) attached?

         No
         Yes


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gov.uscourts.deb.193283.201.0.pdf
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