The liquidator shall preserve a physical or an electronic copy of the reports, registers and books of account referred to in Regulations 8 and 10 for at least eight years after the dissolution of the corporate person, either with himself or with an information utility.
SCHEDULE I
Form A
PUBLIC ANNOUNCEMENT
[Regulation 14 of the Insolvency and Bankruptcy Board of India (Voluntary Liquidation Process) Regulations, 2017]
FOR THE ATTENTION OF THE STAKEHOLDERS OF [Name of Corporate person]
| 1. |
NAME OF CORPORATE PERSON |
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| 2. |
DATE OF INCORPORATION OF CORPORATE PERSON |
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| 3. |
AUTHORITY UNDER WHICH CORPORATE PERSON IS INCORPORATED/REGISTERED |
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| 4. |
CORPORATE IDENTITY NUMBER/LIMITED LIABILITY IDENTITY NUMBER OF CORPORATE PERSON |
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| 5. |
ADDRESS OF THE REGISTERED OFFICE AND PRINCIPAL OFFICE (IF ANY) OF CORPORATE PERSON |
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| 6. |
LIQUIDATION COMMENCEMENT DATE OF CORPORATE PERSON |
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| 7. |
NAME, ADDRESS, EMAIL ADDRESS, TELEPHONE NUMBER AND THE REGISTRATION NUMBER OF THE LIQUIDATOR |
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| 8. |
LAST DATE FOR SUBMISSION OF CLAIMS |
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Notice is hereby given that the [name of the corporate person] has commenced voluntary liquidation on [liquidation commencement date].
The stakeholders of [name of the corporate person] are hereby called upon to submit a proof of their claims, on or before 6[insert the date falling thirty days from the liquidation commencement date], to the liquidator at the address mentioned against Item 7.
The financial creditors shall submit their proof of claims by electronic means only. All other stakeholders may submit the proof of claims in person, by post or by electronic means.
Submission of false or misleading proofs of claim shall attract penalties.
Name and Signature of the Liquidator:
Date and Place:
Form B
PROOF OF CLAIM BY OPERATIONAL CREDITORS EXCEPT WORKMEN AND EMPLOYEES
[Under Regulation 16 of the Insolvency and Bankruptcy Board of India (Voluntary Liquidation Process) Regulations, 2017]
[Date]
To
The Liquidator
[Name of the Liquidator]
[Address as set out in the public announcement]
From
[Name and address of the operational creditor]
Subject: Submission of proof of claim in respect of the voluntary liquidation of [name of corporate debtor] under the Insolvency and Bankruptcy Code, 2016.
Madam/Sir,
[Name of the operational creditor] hereby submits this proof of claim in respect of the voluntary liquidation of [name of corporate debtor]. The details for the same are set out below:
| 1. |
NAME OF OPERATIONAL CREDITOR (IF AN INCORPORATED BODY PROVIDE IDENTIFICATION NUMBER AND PROOF OF INCORPORATION, IF A PARTNERSHIP OR INDIVIDUAL PROVIDE IDENTIFICATION RECORDS* OF ALL THE PARTNERS OR THE INDIVIDUAL) |
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| 2. |
ADDRESS OF OPERATIONAL CREDITOR FOR CORRESPONDENCE |
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| 3. |
TOTAL AMOUNT OF CLAIM, INCLUDING ANY INTEREST, AS AT VOLUNTARY LIQUIDATION PROCESS COMMENCEMENT DATE AND DETAILS OF NATURE OF CLAIM |
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| 4. |
DETAILS OF ANY DISPUTE AS WELL AS THE RECORD OF PENDENCY OF SUIT OR ARBITRATION PROCEEDINGS |
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| 5. |
DETAILS OF HOW AND WHEN DEBT INCURRED |
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| 6. |
DETAILS OF ANY MUTUAL CREDIT, MUTUAL DEBTS, OR OTHER MUTUAL DEALINGS BETWEEN THE CORPORATE PERSON AND THE OPERATIONAL CREDITOR WHICH MAY BE SET-OFF AGAINST THE CLAIM |
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| 7. |
DETAILS OF ANY RETENTION OF TITLE IN RESPECT OF GOODS OR PROPERTIES TO WHICH THE DEBT REFERS OR ANY OTHER SECURITY |
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| 8. |
DETAILS OF ANY ASSIGNMENT OR TRANSFER OF DEBT IN HIS FAVOUR |
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| 9. |
DETAILS OF THE BANK ACCOUNT TO WHICH THE OPERATIONAL CREDITOR'S SHARE OF THE PROCEEDS OF LIQUIDATION CAN BE TRANSFERRED |
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| 10. |
LIST OUT AND ATTACH THE DOCUMENTS RELIED ON IN SUPPORT OF THE CLAIM. |
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| Signature of operational creditor or person authorised to act on his behalf (Please enclose the authority if this is being submitted on behalf of the operational creditor) |
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| Name in BLOCK LETTERS |
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| Position with or in relation to creditor |
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| Address of person signing |
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*PAN, Passport, AADHAAR Card or the identity card issued by the Election Commission of India.
AFFIDAVIT
I, [name of deponent], currently residing at [address of deponent], do solemnly affirm and state as follows:
1. The above named corporate person was, at liquidation commencement date, that is, the .. day of .. 20 and still is, justly and truly indebted to me [or to me and [insert name of co-partners], my co-partners in trade, or, as the case may be] in the sum of Rs. . for .. [please state consideration].
2. In respect of my claim of the said sum or any part thereof, I have relied on and the documents specified below:
[Please list the documents relied on as evidence of debt.]
3. The said documents are true, valid and genuine to the best of my knowledge, information and belief.
4. In respect of the said sum or any part thereof, I have not, nor have my partners or any of them, nor has any person, by my/our order, to my/our knowledge or belief, for my/our use, had or received any manner of satisfaction or security whatsoever, save and except the following:
[Please state details of any mutual credit, mutual debts, or other mutual dealings between the corporate person and the operational creditor which may be set-off against the claim.]
Solemnly, affirmed at .. on day, the . day of . 20 ..
Before me,
Notary/Oath Commissioner
Deponent's signature
VERIFICATION
I, the Deponent hereinabove, do hereby verify and affirm that the contents of para .. to .. of this affidavit are true and correct to my knowledge and belief. Nothing is false and nothing material has been concealed therefrom.
Verified at on this . day of 201 .
Deponent's signature
Form C
PROOF OF CLAIM BY FINANCIAL CREDITORS
[Under Regulation 17 of the Insolvency and Bankruptcy Board of India (Voluntary Liquidation Process) Regulations, 2017]
[Date]
To
The Liquidator
[Name of the Liquidator]
[Address as set out in the public announcement]
From
[Name and address of the registered office and principal office of the financial creditor]
Subject: Submission of proof of claim in respect of the voluntary liquidation of [name of corporate person] under the Insolvency and Bankruptcy Code, 2016.
Madam/Sir,
[Name of the financial creditor] hereby submits this proof of claim in respect of the voluntary liquidation of [name of corporate person]. The details for the same are set out below:
| 1. |
NAME OF FINANCIAL CREDITOR (IF AN INCORPORATED BODY PROVIDE IDENTIFICATION NUMBER AND PROOF OF INCORPORATION, IF A PARTNERSHIP OR INDIVIDUAL PROVIDE IDENTIFICATION RECORDS* OF ALL THE PARTNERS OR THE INDIVIDUAL) |
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| 2. |
ADDRESS AND E-MAIL OF FINANCIAL CREDITOR FOR CORRESPONDENCE. |
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| 3. |
TOTAL AMOUNT OF CLAIM, INCLUDING ANY INTEREST, AS AT THE LIQUIDATION COMMENCEMENT DATE AND DETAILS OF NATURE OF CLAIM (WHETHER TERM LOAN, SECURED, UNSECURED) |
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| 4. |
DETAILS OF ANY ORDER OF A COURT OF TRIBUNAL THAT HAS ADJUDICATED ON THE NON-PAYMENT OF DEBT |
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| 5. |
DETAILS OF HOW AND WHEN DEBT INCURRED |
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| 6. |
DETAILS OF ANY MUTUAL CREDIT, MUTUAL DEBTS, OR OTHER MUTUAL DEALINGS BETWEEN THE CORPORATE PERSON AND THE FINANCIAL CREDITOR WHICH MAY BE SET-OFF AGAINST THE CLAIM |
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| 7. |
DETAILS OF ANY SECURITY HELD, THE VALUE OF THE SECURITY, AND THE DATE IT WAS GIVEN |
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| 8. |
DETAILS OF ANY ASSIGNMENT OR TRANSFER OF DEBT IN HIS FAVOUR |
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| 9. |
DETAILS OF THE BANK ACCOUNT TO WHICH THE FINANCIAL CREDITOR'S SHARE OF THE PROCEEDS OF LIQUIDATION CAN BE TRANSFERRED |
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| 10. |
LIST OUT AND ATTACH THE DOCUMENTS BY REFERENCE TO WHICH THE DEBT CAN BE SUBSTANTIATED AND IN SUPPORT OF THE CLAIM |
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| Signature of financial creditor or person authorised to act on his behalf (Please enclose the authority if this is being submitted on behalf a financial creditor) |
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| Name in BLOCK LETTERS |
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| Position with or in relation to creditor |
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| Address of person signing |
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*PAN, Passport, AADHAAR Card or the identity card issued by the Election Commission of India.
AFFIDAVIT
I, [name of deponent], currently residing at [address of deponent], do solemnly affirm and state as follows:
1. The above named corporate debtor was, at the voluntary liquidation commencement date, that is, the day of .. 20 and still is, justly and truly indebted to me [or to me and [insert name of co-partners], my co-partners in trade, or, as the case may be] in the sum of Rs .. for [please state consideration].
2. In respect of my claim of the said sum or any part thereof, I have relied on the documents specified below:
[Please list the documents relied on as evidence of debt and of non-payment.]
3. The said documents are true, valid and genuine to the best of my knowledge, information and belief.
4. In respect of the said sum or any part thereof, I have not, nor have my partners or any of them, nor has any person, by my/our order, to my/our knowledge or belief, for my/our use, had or received any manner of satisfaction or security whatsoever, save and except the following:
[Please state details of any mutual credit, mutual debts, or other mutual dealings between the corporate person and the financial creditor which may be set-off against the claim.]
Solemnly, affirmed at on day, the day of 20
Before me,
Notary/Oath Commissioner.
Deponent's signature.
VERIFICATION
I, the Deponent hereinabove, do hereby verify and affirm that the contents of para ___ to __of this affidavit are true and correct to my knowledge and belief. Nothing is false and nothing material has been concealed therefrom.
Verified at . on this .. day of .201 .. .
Deponent's signature.
Form D
PROOF OF CLAIM BY A WORKMAN OR EMPLOYEE
[Under Regulation 18(1) of the Insolvency and Bankruptcy Board of India (Voluntary Liquidation Process) Regulations, 2017]
[Date]
To
The Liquidator
[Name of the Liquidator]
[Address as set out in public announcement]
From
[Name and address of the workman/employee]
Subject: Submission of proof of claim in respect of liquidation of (Name of corporate person) under the Insolvency and Bankruptcy Code, 2016.
Madam/Sir,
[Name of the workman/employee], hereby submits this proof of claim in respect of the voluntary liquidation of [name of corporate debtor]. The details for the same are set out below:
| 1. |
NAME OF WORKMAN/EMPLOYEE |
|
| 2. |
PAN, PASSPORT, THE IDENTITY CARD ISSUED BY THE ELECTION COMMISSION OF INDIA OR AADHAAR CARD OF WORKMAN/EMPLOYEE |
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| 3. |
ADDRESS AND E-MAIL ADDRESS (IF ANY) OF WORKMAN/EMPLOYEE FOR CORRESPONDENCE |
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| 4. |
TOTAL AMOUNT OF CLAIM (INCLUDING ANY INTEREST AS AT THE VOLUNTARY LIQUIDATION COMMENCEMENT DATE) |
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| 5. |
DETAILS OF ANY DISPUTE AS WELL AS THE RECORD OF PENDENCY OR ORDER OF SUIT OR ARBITRATION PROCEEDING |
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| 6. |
DETAILS OF HOW AND WHEN CLAIM AROSE |
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| 7. |
DETAILS OF ANY MUTUAL CREDIT, MUTUAL DEBTS, OR OTHER MUTUAL DEALINGS BETWEEN THE CORPORATE PERSON AND THE WORKMAN/EMPLOYEE WHICH MAY BE SET-OFF AGAINST THE CLAIM |
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| 8. |
DETAILS OF THE BANK ACCOUNT TO WHICH THE WORKMAN/EMPLOYEE'S SHARE OF THE PROCEEDS OF LIQUIDATION CAN BE TRANSFERRED |
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| 9. |
LIST OUT AND ATTACH THE DOCUMENTS BY REFERENCE TO WHICH THE DEBT CAN BE SUBSTANTIATED AND RELIED ON IN SUPPORT OF THE CLAIM |
|
| Signature of workman/employee or person authorised to act on his behalf |
| [Please enclose the authority if this is being submitted on behalf of an operational creditor] |
| Name in BLOCK LETTERS |
| Position with or in relation to creditor |
| Address of person signing |
AFFIDAVIT
I, [name of deponent], currently residing at [insert address], do solemnly affirm and state as follows:
1. [Name of corporate debtor], the corporate person was, at the liquidation commencement date, that is, the day of .. 20 , justly and truly indebted to me for a sum of Rs. [insert amount of claim].
2. In respect of my claim of the said sum or any part thereof, I have relied on the documents specified below:
[Please list the documents relied on as evidence of claim]
The said documents are true, valid and genuine to the best of my knowledge, information and belief.
3. In respect of the said sum or any part thereof, I have not nor has any person, by my order, to my knowledge or belief, for my use, had or received any manner of satisfaction or security whatsoever, save and except the following:
[Please state details of any mutual credit, mutual debts, or other mutual dealings between the corporate person and the workman/employee which may be set-off against the claim.]
Solemnly, affirmed at [insert place] on .. day, the ..day of .. 20 ..
Before me,
Notary/Oath Commissioner
Deponent's signature
VERIFICATION
I, the Deponent hereinabove, do hereby verify and affirm that the contents of paragraph to ..of this affidavit are true and correct to my knowledge and belief and no material facts have been concealed therefrom.
Verified at on this . day of 201 ..
Deponent's signature.
Form E
PROOF OF CLAIM BY AUTHORISED REPRESENTATIVE OF WORKMEN OR EMPLOYEES
[Under Regulation 18(2) of the Insolvency and Bankruptcy Board of India (Voluntary Liquidation Process) Regulations, 2017]
[Date]
To
The Liquidator
[Name of the Liquidator]
[Address as set out in the public announcement]
From
[Name and address of the authorised representative of workmen/employees]
Subject: Submission of proof of claim in respect of the liquidation of [name of corporate person] under the Insolvency and Bankruptcy Code, 2016.
Madam/Sir,
I, [name of duly authorised representative of the workmen/employees] currently residing at [address of duly authorised representative of the workmen/employees], on behalf of the workmen and employees employed by the abovenamed corporate person, solemnly affirm and say:
1. That the abovenamed corporate person was, on the voluntary liquidation commencement date, that is, the day of . 20 .. and still is, justly truly indebted to the several persons whose names, addresses, and descriptions appear in the Annexure below for amounts severally set against their names in such Annexure for wages, remuneration and other amounts due to them respectively as workmen or/and employees in the employ of the corporate person in respect of services rendered by them respectively to the corporate person during such periods as are set out against their respective names in the said Annexure.
2. That for which said sums or any part thereof, they have not, nor has any of them, had or received any manner of satisfaction or security whatsoever, save and except the following:
[Please state details of any mutual credits, mutual debts, or other mutual dealings between the corporate person and the workmen/employees which may be set-off against the claim.]
Signature:
ANNEXURE
1. Particulars of how dues were incurred by the corporate person, including particulars of any dispute as well as the record of pendency of suit or arbitration proceedings.
2. Particulars of any mutual credit, mutual debts, or other mutual dealings between the corporate person and the workmen/employee which may be set-off against the claim.
3. Please list out and attach the documents relied on to prove the claim.
Details of Employees/Workmen
| SL. NO. |
NAME OF EMPLOYEE/WORKMEN |
IDENTIFICATION NUMBER (PAN/PASSPORT NUMBER/AADHAAR NO./ID CARD ISSUED BY THE ELECTION COMMISSION AND EMPLOYEE NO., IF ANY |
TOTAL AMOUNT DUE AND DETAILS ON NATURE OF CLAIM |
PERIOD OVER WHICH AMOUNT DUE |
DETAILS OF EVIDENCE OF DEBT INCLUDING EMPLOYMENT CONTRACTS AND OTHER PROOFS |
| 1. |
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| 2. |
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AFFIDAVIT
I, [insert full name, address and occupation of deponent] do solemnly affirm and state as follows:
1. The above named corporate debtor was, at the liquidation commencement date that is, the .. day of .. 20 .. and still is, justly and truly indebted to the workmen and employees for a sum of Rs. . for .. [please state the nature and duration of employment].
2. In respect of my claim of the said sum or any part thereof, I have relied on the documents specified below:
[Please list the documents relied on as evidence of proof]
3. The said documents are true, valid and genuine to the best of my knowledge, information and belief.
4. In respect of the said sum or any part thereof, the workmen/employees have not, nor has any person, by my order, to my knowledge or belief, for my use, had or has received any manner of satisfaction or security whatsoever, save and except the following:
[Please state details of any mutual credit, mutual debts, or other mutual dealings between the corporate person and the workmen/employees which may be set-off against the claim.]
Solemnly, affirmed at on . day, the .day of .. 20 ..
Before me,
Notary/Oath Commissioner.
Deponent's signature
VERIFICATION
I, the Deponent hereinabove, do hereby verify and affirm that the contents of para . to ..of this affidavit are true and correct to my knowledge and belief. Nothing is false and nothing material has been concealed therefrom.
Verified at . on this .day of .. 201 ..
Deponent's signature
Form F
PROOF OF CLAIM BY ANY OTHER STAKEHOLDER
[Under Regulation 19 of the Insolvency and Bankruptcy Board of India (Voluntary Liquidation Process) Regulations, 2017]
[Date]
To
The Liquidator
[Name of the Liquidator]
[Address as set out in the public announcement]
From
[Name and address of the other stakeholder]
Subject: Submission of proof of claim in respect of the liquidation of [name of corporate person] under the Insolvency and Bankruptcy Code, 2016.
Madam/Sir,
[Name of the stakeholder] hereby submits this proof of claim in respect of the liquidation in the case of [name of corporate person]. The details for the same are set out below:
| 1. |
NAME OF STAKEHOLDER (IF AN INCORPORATED BODY PROVIDE IDENTIFICATION NUMBER AND PROOF OF INCORPORATION. IF A PARTNERSHIP OR INDIVIDUAL PROVIDE IDENTIFICATION RECORDS* OF ALL THE PARTNERS OR THE INDIVIDUAL) |
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| 2. |
ADDRESS AND E-MAIL OF THE STAKEHOLDER FOR CORRESPONDENCE. |
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| 3. |
TOTAL AMOUNT OF CLAIM, INCLUDING ANY INTEREST AS AT LIQUIDATION COMMENCEMENT AND DETAILS OF NATURE OF CLAIM |
|
| 4. |
DETAILS OF HOW AND WHEN CLAIM AROSE |
|
| 5. |
DETAILS OF ANY MUTUAL CREDIT, MUTUAL DEBTS, OR OTHER MUTUAL DEALINGS BETWEEN THE CORPORATE PERSON AND THE OTHER STAKEHOLDER WHICH MAY BE SET-OFF AGAINST THE CLAIM |
|
| 6. |
DETAILS OF ANY RETENTION OF TITLE IN RESPECT OF GOODS OR PROPERTIES TO WHICH THE CLAIM REFERS |
|
| 7. |
DETAILS OF ANY ASSIGNMENT OR TRANSFER OF DEBT IN HIS FAVOUR |
|
| 8. |
DETAILS OF THE BANK ACCOUNT TO WHICH THE OTHER STAKEHOLDER'S SHARE OF THE PROCEEDS OF LIQUIDATION CAN BE TRANSFERRED |
|
| 9. |
LIST OUT AND ATTACH THE DOCUMENTS BY REFERENCE TO WHICH THE CLAIM CAN BE SUBSTANTIATED OR WHICH CAN BE RELIED UPON IN SUPPORT OF THE CLAIM |
|
| Signature of stakeholder or person authorised to act on his behalf (Please enclose the authority if this is being submitted on behalf of the other stakeholder) |
| Name in BLOCK LETTERS |
| Position with or in relation to creditor |
| Address of person signing |
*PAN, Passport, AADHAAR Card or the identity card issued by the Election Commission of India.
AFFIDAVIT
I, [insert full name, address and occupation of deponent to be given] do solemnly affirm and state as follows:
1. The above named corporate person was, at the liquidation commencement date, that is, the .. day of . 20 . and still is, justly and truly indebted to me [or to me and [insert name of co-partner], my co-partners in trade, or, as the case may be,] for a sum of Rs. for .. [please state consideration].
2. In respect of my claim of the said sum or any part thereof, I have relied on the documents specified below:
[Please list the documents relied on as evidence of proof.]
3. The said documents are true, valid and genuine to the best of my knowledge, information and belief.
4. In respect of the said sum or any part thereof, I have not, nor have my partners or any of them, nor has any person, by my/our order, to my/our knowledge or belief, for my/our use, had or received any manner of satisfaction or security whatsoever, save and except the following:
[Please state details of any mutual credit, mutual debts, or other mutual dealings between the corporate person and the other stakeholder which may be set-off against the claim.]
Solemnly, affirmed at on day, the day of 20
Before me,
Notary/Oath Commissioner.
Deponent's signature.
VERIFICATION
I, the Deponent hereinabove, do hereby verify and affirm that the contents of para to ..of this affidavit are true and correct to my knowledge and belief. Nothing is false and nothing material has been concealed therefrom.
Verified at . on this . day of 201 ..
Deponent's signature.
7[Form G
Deposit of Unclaimed Dividends and/or Undistributed Proceeds
[Under Regulation 39(5) of the Insolvency and Bankruptcy Board of India (Voluntary Liquidation Process) Regulations, 2017]
A. Details of Voluntary Liquidation Process
| Sl. No. |
Description |
Particulars |
| (1) |
(2) |
(3) |
| 1 |
Name of the Corporate Person |
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| 2 |
Identification Number of Corporate Person (CIN/LLPIN) |
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| 3 |
Voluntary Liquidation Commencement Date |
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| 4 |
Date of Deposit into the Corporate Voluntary Liquidation Account |
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| 5 |
Amount deposited into the Corporate Voluntary Liquidation Account (Rs) |
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| 6 |
Bank Account from which the amount is transferred to Corporate Voluntary Liquidation Account |
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| a. |
Account No.: |
| b. |
Name of Bank: |
| c. |
IFSC: |
| d. |
MICR: |
| e. |
Address of Branch of the Bank: |
| 7 |
Details of the Amount (Rs.) deposited into Corporate Voluntary Liquidation Account |
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| a. |
Unclaimed dividends |
| b. |
Undistributed proceeds |
| c. |
Income earned till the due date of deposit |
| d. |
Interest at the rate of twelve per cent on the amount retained beyond due date (Please show computation of interest amount) |
| Total |
B. Details of stakeholders entitled to Unclaimed Dividends or Undistributed Proceeds
| Sl. No. |
Name of stakeholder entitled to receive unclaimed dividends or undistributed proceeds |
Address, phone number and email address of the stakeholder |
Identification Number of the stakeholder (PAN, CIN/LLPIN/DIN, Aadhaar No.) (Please attach Identification proof.) |
Amount due to the stakeholder (Rs) |
Nature of Amount due |
Remarks |
| (1) |
(2) |
(3) |
(4) |
(5) |
(6) |
(7) |
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C. Details of Deposit made into the Coporate Valuntary Liquidation Account
I (Name of Liquidator) have deposited Rs (Rupees only) into the Corporate Voluntary Liquidation Account on vide Acknowledgement No. dated
I (Name of Liquidator) hereby certify that the details provided in this Form are true and correct to the best of my knowledge and belief, and nothing material has been concealed.
(Signature)
Name of the Liquidator
IP Registration No.:
Date: Address as registered with the Board:
Place: E-mail id as registered with the Board:
Form H
Withdrawal from Corporate Voluntary Liquidation Account
[Under Regulation 39(7) of the Insolvency and Bankruptcy Board of India (Voluntary Liquidation Process) Regulations, 2017]
| Sl. No. |
Description |
Particulars |
| (1) |
(2) |
(3) |
| 1 |
Name of the Corporate Person |
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| 2 |
Identification Number of Corporate Person (CIN/LLPIN) |
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| 3 |
Voluntary Liquidation Commencement Date |
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| 4 |
Date of Dissolution Order |
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| 5 |
Date of Deposit into the Corporate Voluntary Liquidation Account |
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| 6 |
Name of the Stakeholder seeking withdrawal |
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| 7 |
Identification Number of the Stakeholder |
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| a. |
PAN |
| b. |
CIN/LLPIN/DIN |
| c. |
Aadhaar No. |
| 8 |
Address and E-mail Address of Stakeholder |
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| 9 |
Amount of Claim of the Stakeholder, admitted by the Liquidator |
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| 10 |
Amount of unclaimed dividends/undistributed proceeds deposited by the Liquidator in the Corporate Voluntary Liquidation Account against the stakeholder |
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| 11 |
Amount of unclaimed dividends/undistributed proceeds the Stakeholder seeks to withdraw from the Corporate Voluntary Liquidation Account |
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| 12 |
Bank Account to which the amount is to be transferred from the Corporate Voluntary Liquidation Account, if withdrawal is approved |
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| a. |
Account No.: |
| b. |
Name of Bank: |
| c. |
IFSC: |
| d. |
MICR |
| e. |
Address of Branch of the Bank: |
| 13 |
Reasons for not taking dividend or proceeds during the Voluntary Liquidation Process |
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| 14 |
Any legal disability in applying for withdrawal? (Yes/No), If yes, please provide details |
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DECLARATION
I, [Name of stakeholder], currently residing at [insert address], hereby declare and state as follows:
1. I am entitled to receive a sum of Rs (Rupees only) from the Corporate Voluntary Liquidation Account, as presented above.
2. In respect of the said sum or any part thereof, neither I nor any person, by my order, to my knowledge or belief, for my use, has received any manner of satisfaction or security whatsoever, save and except the following:
3. I undertake to refund the entire amount with interest as decided by the Board, in case the Board finds that I am not entitled to this amount.
4. I authorise the Board to initiate appropriate legal action against me if my claim is found false at any time.
Date:
Place:(Signature of the Stakeholder)
VERIFICATION
I, [Name] the stakeholder hereinabove, do hereby verify that the contents of this Form are true and correct to my knowledge and belief and no material fact has been concealed therefrom.
Verified at on this day of , 20 (Signature of the Stakeholder)
[Note: In the case of a company or limited liability partnership, the declaration and verification shall be made by the director/manager/secretary/designated partner and in the case of other entities, an officer authorised for the purpose by the entity].
SCHEDULE II
[Under Regulation 10 of the Insolvency and Bankruptcy Board of India (Voluntary Liquidation Process) Regulations, 2017]
The formats contained in this Schedule are indicative in nature, and the liquidator may make such modifications to them as he deems fit in view of thefacts and circumstances of the liquidation.
CASH BOOK
Name of Corporate Person .(in liquidation)
| Date |
Particulars |
Ledger Folio No. |
Receipt |
Payments |
Balance |
| |
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Voucher No. |
Cash |
Bank |
Total |
Voucher No. |
Cash |
Bank |
Total |
Cash |
Bank |
Total |
| 1 |
2 |
3 |
4 |
5 |
6 |
7 |
8 |
9 |
10 |
11 |
12 |
13 |
14 |
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Under particulars , the head of account to which the entry relates to should be indicated so that the entry may be posted under the proper head in the General Ledger.
GENERAL LEDGER
Name of Corporate Person . (in liquidation)
. (Head of account)
| Date |
Particulars |
Dr. (Rs) |
Cr. (Rs) |
Balance (Rs) |
| 1 |
2 |
3 |
4 |
5 |
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Instructions:
1. A General Ledger should be maintained with such heads of account as the liquidator may think necessary and appropriate. The following heads of account may be found suitable:
(1) Asset account
(2) Investments account
(3) Book Debts & Outstandings account
(4) Calls
(5) Rent Collected/rent receivable
(6) Interest on Securities and Deposits
(7) Advances received
(8) Miscellaneous receipts payments
(9) Establishment
(10) Legal charges
(11) Rents, Rates and Taxes payable
(12) Fees and Commission account
(13) Other expenses
(14) Suspense account
(15) Secured creditors
(16) Dividend account.
2. The entries in the General Ledger should be posted from the Cash Book.
3. The total of the debit balances and the total of the credit balances of the several heads of account in the General Ledger should agree, after taking into consideration the cash and bank balances as shown in the Cash Book. The totals should be tallied once a month.
BANK LEDGER
Corporate debtor's (in voluntary liquidation) account with the Scheduled Bank
| Date |
Particulars |
Deposits |
Withdrawals |
Balance |
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Challan Number |
Rs |
Cheque Number |
Rs |
Rs |
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2 |
3 |
4 |
5 |
6 |
7 |
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REGISTER OF ASSETS
| Sl. No. |
Description of assets |
Date of taking possession |
Serial number of Sales Register |
Date of sale |
Date of realisation |
Amount |
Remarks |
| 1 |
2 |
3 |
4 |
5 |
6 |
7 |
8 |
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Instructions:
1. All the assets of the corporate person except the liquidator's investments in securities and outstanding to be realised should be entered in this Register.
SECURITIES AND INVESTMENTS REGISTER
| Sl. No. |
Petition number and name of the corporate debtor |
Date of investment |
Nature and particulars of security in which investment is made |
Amount Invested (Rs) |
Dividend or interest received with date of receipt (Rs) |
Date of disposal |
Remarks |
| 1 |
2 |
3 |
4 |
5 |
6 |
7 |
8 |
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REGISTER OF BOOK DEBTS AND OUTSTANDINGS
| Sl. No. |
Name and address of debtor |
Particulars of debt |
Amount due (Rs) |
Date of bar by limitation |
Amount realised (Rs) |
Action taken |
Date of realisation |
Reference to Suits Register |
Remarks |
| 1 |
2 |
3 |
4 |
5 |
6 |
7 |
8 |
9 |
10 |
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Instructions:
1. All debts due to the corporate person, both secured and unsecured, including amounts due for arrears of calls made prior to the liquidation, should be entered in this Register.
TENANTS LEDGER
1. Description of assets:
2. Name and address of tenant:
3. Date of tenancy:
4. Period of tenancy:
5. Rent (monthly or annual):
6. Special terms, if any:
7. Arrears on date of taking charge of assets:
8. Advance received, if any:
| Month |
Demand |
Realisation |
Balance |
Remarks |
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Amount (Rs) |
Date |
Amount (Rs) |
Amount (Rs) |
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2 |
3 |
4 |
5 |
6 |
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SUITS REGISTER
| Sl. No. |
Number of suit or appeal and court |
Name and address of plaintiff/appellant and his advocate |
Name and address of defendant/respondent and his advocate |
Amount of claim |
Date of filing |
Dates of hearing |
Date of decree or final order |
Nature of relief granted |
Amount decreed |
Costs decreed |
Reference to Decree Register |
Remarks |
| 1 |
2 |
3 |
4 |
5 |
6 |
7 |
8 |
9 |
10 |
11 |
12 |
13 |
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Instructions:
1. Applications made by or against the corporate person which are in the nature of suits should also be entered in this Register.
DECREE REGISTER
| Number of suit or appeal and court |
Name and address of judgment debtor |
Amount Decreed (Rs.) |
Date of decree |
Action taken |
Amount realised (Rs.) |
Date of realisation |
Reference to Suits Register |
| 1 |
2 |
3 |
4 |
5 |
6 |
7 |
8 |
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Instructions:
1. The purpose of the Register is to enable the liquidator to keep watch on the progress of the realisation of decrees in favour of the corporate person in his charge.
2. Every decree or order for payment of money or delivery of assets in favour of the corporate person including an order for payment of costs whether made in a suit, appeal or application, should be entered in this Register.
REGISTER OF CLAIMS AND DISTRIBUTIONS
| Claims |
Distributions declared and paid |
Re-marks |
| Sl. No. |
Name and Add-ress of credi-tor |
Amo-unt clai-med (Rs) |
Nat-ure of cla-im (Rs) |
Am-ount adm-itted (Rs) |
Whe-ther ordi-nary or pref-eren-tial |
Date |
Am-ount (Rs) |
Date and mode of pay-ment |
Rate |
Am-ount (Rs) |
Date and mode of pay-ment |
Rate |
Am-ount (Rs) |
Date and mode of pay-ment |
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| 1 |
2 |
3 |
4 |
5 |
6 |
7 |
8 |
9 |
10 |
11 |
12 |
13 |
14 |
15 |
16 |
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Instructions:
1. Only claims admitted either wholly or in part should be entered in this Register.
2. The page on the left side should be reserved for claims and the page on the right side for Distributions.
CONTRIBUTORY'S LEDGER
| Sl. No. |
Name and |
Number |
Calls |
Remarks |
Returns of share capital |
Remarks |
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address of contributory |
of shares or extent of interest |
First call |
2nd call/3rd call |
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Date of return |
Date of Payment |
Amount paid (Rs) |
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held, and amount paid thereon |
Date of call and amount called |
Amount paid and date of payment |
(Repeat columns as under first call) |
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2 |
3 |
4 |
5 |
6 to 9 |
10 |
11 |
12 |
13 |
14 |
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Instructions: Only contributories settled on the list should be entered in this Register and they should be entered in the same order as in the list.
DISTRIBUTIONS REGISTER
Date on which distribution is made:
Total amount payable in this round of distribution:
| Date |
Number on list of stakeholders |
Particulars |
Receipts |
Payments |
| 1 |
2 |
3 |
4 |
5 |
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Instructions:
1. Separate pages should be set apart for preferential and ordinary distributions.
2. The payments should be entered as and when they are made. Any amount which is returned unpaid should be re-entered in the account under Receipts .
3. The number in Column 2 should be the number of the stakeholders in the list of stakeholders as finally settled.
4. The total amount of unclaimed distribution payable into the 8[Corporate Voluntary Liquidation Account], and the amount paid into the Bank with the date of payment, should be shown at the end of the account.
FEE REGISTER
| Amount realised on which fee are payable |
Amount distributed on which fee are payable |
Fee payable on the amounts in the two preceding columns |
Total fee payable |
Date of payment |
| 1 |
2 |
3 |
4 |
5 |
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Instructions:
1. There should be a fresh opening for each year.
2. The fees due to the liquidator should be entered in the Register as soon as the audit of the account for a quarter is completed.
SUSPENSE REGISTER
| Date |
Particulars |
Debit (Rs) |
Credit (Rs) |
Balance (Rs) |
| 1 |
2 |
3 |
4 |
5 |
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Instructions:
1. Advances made by the liquidator to any person should be entered in this Register.
2. There should be a separate opening for each person.
DOCUMENTS REGISTER
| Sl. No. |
Description of document |
Date of receipt |
From whom received |
Reference number of shelf in which document is kept |
How disposed of |
Remarks |
| 1 |
2 |
3 |
4 |
5 |
6 |
7 |
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Instruction: All documents of title like title-deeds, shares, promissory notes, etc., should be entered in this Register.
BOOKS REGISTER
| Date |
From whom received |
Serial Number |
Description of books, including files |
Shelf number |
How disposed of |
Remarks |
| 1 |
2 |
3 |
4 |
5 |
6 |
7 |
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Instruction: All books and files of the corporate debtor which come into the hands of the liquidator should be entered in this Register.
REGISTER OF UNCLAIMED DIVIDENDS AND UNDISTRIBUTED 9[PROCEEDS] DEPOSITED
| Sl. No. |
Name of person entitled to the dividend or return |
Whether Creditor or Contributory |
Number on list of stakeholders |
Date of declaration of dividend or return |
Rate of dividend or return |
Total amount payable (Rs) |
| 1 |
2 |
3 |
4 |
5 |
6 |
7 |
| 1. |
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