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Withdrawal of Claim #2

Date
2024-10-02

Summary

A Withdrawal of Claim filed July 11, 2025 as Doc 1115 in Case 24-11217-BLS in the United States Bankruptcy Court for the District of Delaware. The creditor, the Louisiana Department of Revenue, withdraws Court Claim Number 26 against the debtor in Case No. 24-11234, a claim filed with a total amount of $23,334.87. The form authorizes the Clerk of the Court or its Claims Agent to reflect the withdrawal on the official claims register. It is signed and dated 7/9/2025 by a Revenue Tax Specialist for the creditor. The one-page form also carries definitions and instructions for completing a withdrawal of claim.

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Full text

Case 24-11217-BLS Doc1115 Filed 07/11/25 Page1of1

United States Bankruptcy Court for the District Delaware

WITHDRAWAL OF CLAIM

Debtor Name and Case Number: |\/yaire Medical 211 Inc; 24-11234

LOUISIANA DEPARTMENT OF REVENUE
Creditor Name and Address: | PO BOX 66658
BATON ROUGE, LA 70896

Court Claim Number (if known): 26

Date Claim Filed: 1 0/2/2024
Total Amount of Claim Filed: $23,334.87

|, the undersigned, am the above-referenced creditor, or an authorized signatory for the above-referenced
creditor. | hereby withdraw the above-referenced claim and authorize the Clerk of this Court, or their
duly appointed Claims Agent, to reflect this withdrawal on the official claims register for the above-
referenced Debtor.

7/9/2025 Ericka Matthews 2wtysirredby Ericka Matthews

Dated: Signature
Print Name: Ericka Matthews
Title (if applicable): Revenue Tax Specialist
DEFINITIONS
Debtor

The person, corporation, or other entity that has filed a bankruptcy case is called the debtor.

Creditor
A creditor is any person, corporation, or other entity to which the debtor owed a debt.

Proof of Claim
A form filed with the clerk of the bankruptcy court where the bankruptcy case was filed, to tell the bankruptcy court how much the debtor owed a
creditor (the amount of the creditor’s claim).

ITEMS TO BE COMPLETED ON THIS WITHDRAWAL OF CLAIM

Court, name of Debtor and Case Number:
Fill in the name of the federal judicial district where the bankruptcy was filed (for example, Central District of California), the name of the debtor in the
bankruptcy case, and the bankruptcy case number. If you received a notice of the case from the court, all of this information is near the top of the notice.

Information about Creditor:
Complete the section giving the name and address of the creditor that was listed on the previously filed Proof of Claim form.

Information identifying the Claim that is to be withdrawn:
Complete the section giving the court claim number, date claim was filed and total amount of claim filed to help identify the claim that is to be withdrawn

Sign and print the name and title, if any, of the creditor or other person authorized to file this withdrawal of claim (attach copy of power of attorney, if
any).

This form must be filed with the clerk of the bankruptcy court where the bankruptcy case was filed or, if applicable, with
their duly appointed Claims Agent as per any procedure approved by the court in the above-referenced bankruptcy
proceeding.

File and source

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gov.uscourts.deb.193283.1115.0.pdf
Size
128,931 bytes
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f8b994f1e3737d2fb471b30a10645c360f112212f66b35d4e36321bfb2461481
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gov.uscourts.deb.193283.1115.0.pdf
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