OFFICE OF THE UNITED STATES TRUSTEE
INITIAL REPORTING REQUIREMENTS FOR ALL CHAPTER 11
DEBTORS (File with U.S. Trustee within 20 days after
petition filing.)
Debtors are required to submit copies of items 1-6 only if they were previously
prepared.
- --------------------------------------------------------------------------
Document Previously Explanation
Required Documents Attached Submitted Attached
- --------------------------------------------------------------------------
1. Most recently prepared annual (x) ( ) ( )
financial statements (balance sheet
and statement of income) Form 10-K
(as amended) for period ended
6/30/96.
2. Most recently prepared (other (x) ( ) ( )
than annual) balance sheet. Form
10-Q for period ended 9/30/96.
3. Most recently prepared (other (x) ( ) ( )
than annual) statement of income.
Form 10-Q for period ended 9/30/96.
4. Most recently filed State and (x) ( ) ( )
Federal Payroll tax return. Quarter
ended 9/30/96.
5. Most recently filed State and ( ) ( ) (x)
Federal Income Tax return. See
explanation attached.
6. Most recently filed State sales ( ) ( ) (x)
tax return. Not applicable.
7. Proof of establishment of ( ) ( ) (x)
Debtor-in-Possession bank
accounts (submit voided checks).
Not applicable.
8. Proof of insurance (submit (x) ( ) ( )
declaration of pages).
The undersigned individual certifies under penalty of perjury (28 U.S.C. Section
1746) that to the best of the individual's knowledge, the documents appended are
the most recently prepared and/or available.
By: ________________________ Dated:__________________, 19__
------------------------------
Title of Debtor Representative
Exhibit 2
OFFICE OF THE UNITED STATES TRUSTEE -- REGION 3
MONTHLY REPORTING REQUIREMENTS
All Chapter 11 debtors must serve the U.S. Trustee with the documents and
reports identified below no later than the 15th day of the month following the
end of the month covered by the report.
Debtor Name: Capital Gaming International, Inc.
Case Number: 96-19829 (JHW)
For the month of: December 23-31, 1996
- --------------------------------------------------------------------------
Document Previously Explanation
Required Documents Attached Submitted Attached
- --------------------------------------------------------------------------
1. Income Statement (x) ( ) ( )
2. Balance Sheet (x) ( ) ( )
3. Statement of Cash Receipts and (x) ( ) ( )
Disbursements
4. Statement of Aged Receivables (x) ( ) ( )
5. Statement of Aged Payables (x) ( ) ( )
6. Statement of Operations, Taxes, (x) ( ) ( )
Insurance and Personnel
7. Tax Receipts ( ) ( ) (x)
8. Other documents/ reports as
required by the U.S. Trustee ( ) ( ) ( )
- -----------------------------------
- -----------------------------------
The undersigned individual certifies under penalty of perjury (28 U.S.C. Section
1746) that to the best of the individual's
knowledge, the documents appended are the most recently prepared and/or
available.
By: ________________________ Dated:__________________, 19__
------------------------------
Title of Debtor Representative
Exhibit 3
OFFICE OF THE UNITED STATES TRUSTEE -- REGION 3
INCOME STATEMENT: Accrual Basis
For the Month Ending: December 31, 1996 (8 days)
Debtor Name: Capital Gaming International, Inc.
Case Number: 96-19829 (JHW)
Current Prior
Month Month
(8 days)
Gross Revenues 25,806
Less: Returns and Allowances --
Net Revenues 25,806
Cost of Sales: (1) --
Beginning Inventory --
Add: Purchases --
Less: Ending Inventory --
Cost of Goods Sold --
Other Operating Expenses: --
Officers Salaries 19,162
Direct Labor/Salaries 4,461
Benefits/Payroll Taxes 2,384
Supplies --
Insurance --
Rent 959
Depreciation & Amortization 1,291
General & Administrative 1,317
Net Operating Profit (Loss) (3,768)
Add: Other Income (2) 10,057*
Less: Other Expenses --
Interest Expense 0
Other (3) 30,087**
Total Other Expenses 30,087
Gain (Loss) Sale of Assets --
Profit (Loss) Before Taxes (23,798)
Income Taxes 0
Net Profit (Loss) (23,798)
1. If perpetual inventory records are not maintained, use of the prior period
gross profit percentage is acceptable but must be disclosed.
2. Identify the source if the amount is $500.00 or more.
3. Provide details on "other" expenses over $500.00.
* Other Income
Interest income on note receivable from wholly-owned subsidiary, Capital
Gaming Management, Inc.
** Other Expenses
Amortization of deferred finance cost and original issue discount $30,087.
Exhibit 4
OFFICE OF THE UNITED STATES TRUSTEE -- REGION 3
BALANCE SHEET As of 12/31/96
Debtor Name: Capital Gaming International, Inc.
Case Number: 96-19829 (JHW) Initial Month
ASSETS (Book Value) Current Month Prior Month
Current Assets
Cash (includes $300
cash on hand)
86,870 ___________
Inventory -- ___________
Accounts Receivable 2,100,000 ___________
Notes Receivable 4,545,216 ___________
Other (attach list)
Deposits and prepaids
444,350 ___________
-----------
Total Current Assets 7,176,436 ___________
-----------
Fixed Assets
Property and Equipment 135,698 ___________
Accumulated Depreciation 53,262 ___________
----------
Total Fixed Assets 82,436
Other (attach list) Assets 9,896,936 ___________
-----------
TOTAL ASSETS 17,155,808
=========== ===========
LIABILITIES
Post-petition Liabilities
Accounts Payable 746 ___________
Notes Payable 0 ___________
Rents & Leases Payable 0 ___________
Taxes Payable 0 ___________
Accrued Interest 0 ___________
Other: ________________ -- ___________
-----------
Total Post-petition Liabilities 746 ___________
-----------
Pre-petition Liabilities
Unsecured Debt 28,765,925 ___________
Notes Payable-Secured 103,635,927 ___________
Other Debt (priority claims)
Taxes 0 ___________
Wages 8,000 ___________
Deposits -- ___________
Other: ________________ -- ___________
Total Pre-petition Liabilities 132,409,852
=========== ===========
TOTAL LIABILITIES 132,410,598
OWNER EQUITY (DEFICIT) ___________
Preferred Stock -- ___________
Common Stock 37,617,099 ___________
Capital Surplus 7,877,002 ___________
Retained Earnings (160,748,891)
PARTNERS' INVESTMENT (DEFICIT) ___________
TOTAL OWNER EQUITY (NET WORTH) (115,254,790)
=========== ===========
TOTAL LIABILITIES AND OWNER EQUITY
17,155,808
=========== ===========
NOTES:
1. Explain significant events, including
contingent liabilities and pending lawsuits,
which may have a material effect on the
financial condition of the debtor.
2. Value assets at lower of cost or market and
identify which method is being used.
3. Explain the method of inventory valuation if
other than the lower of cost or market.
4. Identify any changes in stock holdings of
"insiders" during the reporting period.
=========== ==========
Capital Gaming International, Inc.
Schedule of Other Assets
31-Dec-96
Cash escrow held by bond trustee $ 937,047
Cash escrow held by CCCD/RCJV bankruptcy trustee -- (1)
Advances to CDGC subsidiary 2,165,975
Intangible assets 6,793,914
---------
Total 9,896,936
=========== ===========
(1) $500,000 escrow balance subject to offset by CCCD/RCJV bankruptcy trustee
and also subject to claims of Capital Gaming International, Inc. secured
creditors.
Exhibit 5
OFFICE OF THE UNITED STATES TRUSTEE -- REGION 3
STATEMENT OF CASH RECEIPTS AND DISBURSEMENTS
For the Month Ending: December 31, 1996 (8 days)
Debtor Name: Capital Gaming International, Inc.
Case Number: 96-19829 (JHW)
Account Name: Capital Gaming International, Inc.
Depository: PNC Bank
CASH RECEIPTS
(attach additional sheets as necessary)
Date Description (Source) Amount
---- -------------------- ------
Beginning Cash Balance $(1,430)
12/29/96 Cash received from CGMI
Total Cash Receipts $88,000
- --------------------------------------------------------------------------------
CASH DISBURSEMENTS
(attach additional sheets as necessary)
Date Check No. Payee Description Amount
---- --------- ----- ----------- ------
None
Total Cash Disbursements $ 0
Adjustments (explain) $ --
Ending Cash Balance (must be reconcilable to the
bank statement for account cited above) $86,570
Exhibit 4
OFFICE OF THE UNITED STATES TRUSTEE -- REGION 3
BALANCE SHEET As of 12/31/96
Debtor Name: Capital Gaming International, Inc.
Case Number: 96-19829 (JHW)
ASSETS (Book Value) Initial Month
Current Assets
Cash (includes $300 cash on hand) 86,870
Inventory --
Accounts Receivable 2,100,000
Notes Receivable 4,545,216
Other -- Deposits and prepaids 444,350
-----------
Total Current Assets 7,176,436
Fixed Assets
Property and Equipment 135,698
Accumulated Depreciation 53,262
Total Fixed Assets 82,436
Other Assets (attach list) 9,896,936
TOTAL ASSETS 17,155,808
==========
LIABILITIES
Post-petition Liabilities
Accounts Payable 746
Notes Payable 0
Rents & Leases Payable 0
Taxes Payable 0
Accrued Interest 0
Other --
-----------
Total Post-petition Liabilities 746
Pre-petition Liabilities
Unsecured Debt 28,765,925
Notes Payable - Secured 103,635,927
Other Debt (priority claims)
Taxes 0
Wages 8,000
Deposits --
Other --
Total Pre-petition Liabilities 132,409,852
TOTAL LIABILITIES 132,410,598
===========
OWNER EQUITY (DEFICIT)
Preferred Stock
Common Stock 37,617,099
Capital Surplus 7,877,002
Retained Earnings (160,748,891)
PARTNERS' INVESTMENT (DEFICIT)
TOTAL OWNER EQUITY (NET WORTH) (115,254,790)
===========
TOTAL LIABILITIES AND OWNER EQUITY 17,155,808
===========
NOTES
1. Explain significant events, including contingent liabilities and pending
lawsuits, which may have a material effect on the financial condition of the
debtor.
2. Value assets at lower of cost or market and identify which method is being
used.
3. Explain the method of inventory valuation if other than the lower of cost or
market.
4. Identify any changes in stock holdings of "insiders" during the reporting
period.
Capital Gaming International, Inc.
Schedule of Other Assets
31-Dec-96
Cash escrow held by bond trustee $ 937,047
Cash escrow held by CCCD/RCJV bankruptcy trustee -- (1)
Advances to CDGC subsidiary 2,165,975
Intangible assets 6,793,914
Total 9,896,936
==========
(1) $500,000 escrow balance subject to offset by CCCD/RCJV bankruptcy trustee
and also subject to claims of Capital Gaming International, Inc. secured
creditors.
Exhibit 5
OFFICE OF THE UNITED STATES TRUSTEE -- REGION 3
STATEMENT OF CASH RECEIPTS AND DISBURSEMENTS
For the Month Ending: December 31, 1996 (8 days)
Debtor Name: Capital Gaming International, Inc.
Case Number: 96-19829 (JHW)
Account Name: Capital Gaming International, Inc.
Depository: PNC Bank
CASH RECEIPTS
(attach additional sheets as necessary)
Date Description (Source) Amount
---- -------------------- ------
Beginning Cash Balance $(1,430)
12/29/96 Cash received from CGMI 88,000
Total Cash Receipts $88,000
- --------------------------------------------------------------------------------
CASH DISBURSEMENTS
(attach additional sheets as necessary)
Date Check No. Payee Description Amount
---- --------- ----- ----------- ------
None
Total Cash Disbursements $ 0
Adjustments (explain) $
Ending Cash Balance (must be reconcilable to the
bank statement for account cited above) $86,570
Exhibit 6
OFFICE OF THE UNITED STATES TRUSTEE -- REGION 3
STATEMENT OF AGED RECEIVABLES
For the month Ending: 12/31/96
Debtor Name: Capital Gaming International, Inc.
Case Number: 96-19829 (JHW)
================================================================================
Total Due: Current Past Due Past Due Past Due
(0-30 Days) (31-60 Days) (61-90 Days) (91+ Days)
- --------------------------------------------------------------------------------
Pre-petition
- ------------
CGMI
2,074,194 74,194 100,000 100,000 1,800,000
Post-petition
- ------------
CGMI
25,806 25,806
Totals
- ------------
2,100,000 100,000 100,000 100,000 1,800,000
================================================================================
Notes:
1. Please explain what actions have been taken to collect receivables more than
60 days past due.
Receivables are due from Capital Gaming Management, Inc. ("CGMI"), a
wholly-owned subsidiary. Payments are allocated first to the note receivable and
the residual amount is allocated to the service agreement receivable.
2. Provide details on all receivables due from any affiliate of debtor in an
attachment.
Receivables arise from management services agreement between Capital Gaming
International, Inc. and its wholly-owned subsidiary, CGMI.
ACCOUNTS RECEIVABLE RECONCILIATION:
1. Opening Balance (total from prior report) 2,074,194
2. New Accounts this Month 25,806
3. Balance (add lines 1 and 2) 2,100,000
4. Amount Collected on Prior Accounts 0
5. Closing Balance (subtract line 4 from line 3) 2,100,000
Exhibit 7
OFFICE OF THE UNITED STATES TRUSTEE -- REGION 3
STATEMENT OF AGED PAYABLES
--------------------------
For the month Ending: December 31, 1996
Debtor Name: Capital Gaming International, Inc.
Case Number: 96-19829 (JHW)
================================================================================
Total Due: Current Past Due Past Due Past Due
(0-30 Days) (31-60 Days) (61-90 Days) (91+ Days)
- --------------------------------------------------------------------------------
Federal Express Courier 167
Skidmore Art Design 243
Consultants
Sprint Phone 83
A Business Phone 193
Conference Call
Disclosure Info. Legal Research 60
Centers Service
TOTALS: 746
================================================================================
You may combine all payables less than 30 days past due and show on one line.
Note: Please include only post-petition debts and explain why accounts over 30
days past due have not been paid.
- --------------------------------------------------------------------------------
ACCOUNTS RECEIVABLE RECONCILIATION:
1. Opening Balance (total from prior report) 0
2. Total New Indebtedness Incurred This Month 746
3. Balance (add lines 1 and 2) 746
4. Amount Paid on Prior Accounts Payable 0
5. Closing Balance (subtract line 4 from line 3) 746
Exhibit 8
OFFICE OF THE UNITED STATES TRUSTEE -- REGION 3
STATEMENT OF OPERATIONS, TAXES, INSURANCE AND PERSONNEL
-------------------------------------------------------
For the month Ending: December 31, 1996
Debtor Name: Capital Gaming International, Inc.
Case Number: 96-19829 (JHW)
1. What efforts have been made toward the preparation of a plan of
reorganization?
A Plan of Reorganization was filed by the Debtor simultaneously with filing the
Voluntary Petition (December 23, 1996)
2. Has the debtor, subsequent to the filing of the petition, made any payments
on its pre-petition unsecured debt, except as have been authorized by the
Court?
___ Yes
_X_ No
Identify amount, who was paid and date paid:------------------------------------
- --------------------------------------------------------------------------------
- --------------------------------------------------------------------------------
3. Provide a narrative report of significant events affecting debtor's
business (attach separate sheet if necessary).
- --------------------------------------------------------------------------------
- --------------------------------------------------------------------------------
4. List any payment(s) on debt that has been personally guaranteed by any
principal, partner or officer of the business.
N/A
- --------------------------------------------------------------------------------
- --------------------------------------------------------------------------------
5. If assets have been sold in other than the ordinary course of business,
please provide details as to the assets sold, date of sale, total sales
price, deductions (i.e. commissions), and net amount received.
N/A
- --------------------------------------------------------------------------------
- --------------------------------------------------------------------------------
6. STATUS OF TAXES N/A - no post-petition taxes withheld or owed.
- --------------------------------------------------------------------------------
Amount Withheld or
Accrued Post-Petition
Amount Paid Date Paid Taxes Past Due
- --------------------------------------------------------------------------------
FEDERAL TAXES
FICA
Withholding
Unemployment
Income
Other
STATE TAXES
Dept. of Labor &
Industries
Income
Employment Sec.
Dept. of Revenue
B&O
Sales
Excise
OTHER TAXES
City Business
License
Personal Property
Real Property
Other (List)
Explain reason for any past due post-petition taxes:
N/A
- --------------------------------------------------------------------------------
- --------------------------------------------------------------------------------
- --------------------------------------------------------------------------------
7. SCHEDULE OF SALARY AND OTHER PAYMENTS TO PRINCIPALS/ EXECUTIVES/INSIDERS*
Nature of
Payee Name Position Payment Amount
- --------------------------------------------------------------------------------
Edward M. Tracy President and CEO Accrual $10,645
- --------------------------------------------------------------------------------
Clinton L. Pagano Exec. VP or Compliance Accrual $ 2,151
- --------------------------------------------------------------------------------
William S. Papazian Sr. VP and Gen. Counsel Accrual $ 4,301
- --------------------------------------------------------------------------------
Cory Morowitz Acting CFO Accrual $ 2,065
- --------------------------------------------------------------------------------
List accrued salaries whether or not paid and any draws of any kind or perks
such as car etc. made to or for the benefit of any proprietor, owner, partner,
shareholder, officer, director or insider.
8. SCHEDULE OF PAYMENTS TO ATTORNEYS AND OTHER PROFESSIONALS
Appointment Amount Paid Date of Court Aggregate Estimated
Date This Month Approval Received Balance Due
Debtor's Counsel $ None $ $ None
Creditors' $ $ $
Committee
Counsel
Trustee Counsel $ $ $
Accountant S $ $
Other $ $ $
Identify fees accrued but not paid: Not aware of any
9. Explain any changes in insurance coverage which occurred during the
reporting period.
There were no changes in insurance coverage.
10. PERSONNEL
================================================================================
Full Time Part Time
- --------------------------------------------------------------------------------
Total number of employees at
beginning of period 8 0
- --------------------------------------------------------------------------------
Number hired during the period 0 0
- --------------------------------------------------------------------------------
Number terminated or resigned
during period 0 0
- --------------------------------------------------------------------------------
Total number of employees on
payroll at period end 8 0
================================================================================
Total payroll for the period $23,623 Allocated from payment
------- made pre-petition