KB-1369

FORM NO. CAA.10

[Pursuant to section 233(1)(c) and  rule 25(2)]
Declaration of solvency

1. (a) Corporate identity number (CIN) of company :

    (b) Global location number (GLN) of company:

2. (a) Name of the company:

    (b) Address of the registered office of the company:

    (c) E-mail ID of the company:

3.(a)  Whether the company is listed:

?       Yes

?       No

   (b) If listed, please specify the name(s) of the stock exchange(s) where listed:

       ———————————————————————-  

       ——————————————————————–

4. Date of Board of Directors’ resolution approving the scheme

Declaration of solvency

We, the directors of M/s …………………. do solemnly affirm and declare that we have made a full enquiry into the affairs of the company and have formed the opinion that the company is capable of meeting its liabilities as and when they fall due and that the company will not be rendered insolvent within a period of one year from the date of making this declaration.

We append an audited statement of company’s assets and liabilities as at ………… being the latest date of making this declaration.

We further declare that the company’s audited annual accounts including the Balance Sheet have been filed upto date with the Registrar of Companies …………………..

Signed for and behalf of the board of directors

                                         (1) Signature             :……………

Date                                       Name                  :…………..

Place                                      Managing Director, if any

                                         (2) Signature             :……………

                                              Name                  :……………

                                              Director

                                         (3) Signature             :…………….

                                              Name                  :…………….

                                              Director

Verification

We solemnly declare that we have made a full enquiry into the affairs of the company including the assets and liabilities of this company and that having done so and having noted that the scheme of   merger or amalgamation between ………………… and …………………………..is proposed to be placed before the  shareholders and creditors of the company for approval as per the provisions of sub-section of (1) of section 233  of the Companies Act, 2013, we make this solemn declaration believing the same to be true.

Verified this day the ……… day of …………….., 20……

                                         (1) Signature             :……………

                                              Name                  :…………..

                                              Managing Director

                                         (2) Signature             :……………

                                              Name                  :……………

                                              Director

                                         (3) Signature             :…………….

                                              Name                  :…………….

                                              Director

Solemnly affirmed and declared at ………… the ………………. day of ……………, 20… before me.

                                           Commissioner of Oaths and

                                           Notary Public 

Attachments:

a)        Copy of board resolution

b)        Statement of assets and liabilities

c)        Auditor’s report on the statement of assets and liabilities

ANNEXURE

Statement of assets and liabilities as at ……….

Name of the company …………………….

Assets

                                                 Book              Estimated

                                                 Value      Realisable value                                         

1. Balance at Bank

2. Cash in hand

3. Marketable securities

4. Bills receivables

5. Trade debtors

6. Loans & advances

7. Unpaid calls

8. Stock-in-trade

9. Work in progress

10. Freehold property

11. Leasehold property

12. Plant and machinery

13. Furniture, fittings, utensils, etc.

14. Patents, trademarks, etc.

15. Investments other than

     marketable securities

16. Other property

                                               ……………………   ……………………

                                     Total:      

                                               ………………….     ……………………

Liabilities

                                             Estimated to rank for payment       

                                                (to the nearest rupee)

1.   Secured on specific assets

2.   Secured by floating charge(s)

3.   Estimated cost of liquidation

    and other expense including

    interest accruing until payment

of debts in full.

4.   Unsecured creditors

    (amounts estimated

    to rank for payment)

(a)    Trade accounts

(b)    Bills payable

(c)     Accrued expense

(d)    Other liabilities

(e)    Contingent liabilities

                                                             ………………………..

                                                  Total:

                                                             ………………………..

Total estimated value of assets             Rs.     ………………………

Total liabilities                                     Rs.     ………………………

Estimated surplus after paying              Rs.     ………………………

debts in full

Remarks                            (1) Signature             :……………

                                              Name                  :…………..

                                              Managing Director

                                         (2) Signature             :……………

                                              Name                  :……………

                                              Director

                                         (3) Signature             :…………….

                                              Name                  :…………….

                                              Director

Place : ……………

Date: ………….