Form No. 37 - Statement of affairs under rule 28 - Limited Liability Partnership (Winding up and Dissolution) Rules, 2010

Form No. 37 [ See rule 126] [Heading as in Form No. 16] LLP Petition No. ..........of 20....... Statement of affairs under rule 28 Statement of affairs of the above-named LLP as on the......... day of..........20...., the date of petition or the winding up order or the order appointing Provisional Liquidator, as the case may be. I/We............... of.......... do solemnly affirm and say that the statement made overleaf and the several lists hereunto annexed marked A to G are to the best of my/our knowledge and belief a full, true and complete statement as to the affairs of the above LLP, on the........day of.......20......., the date of the petition or winding-up order or the order appointing Provisional Liquidator and that the said LLP carried/carried on the following business : (Here set out nature of LLP business) ................... Signature(s) Solemnly affirmed at............... This........ day of........20.... Before me. Commissioner of Oaths or Notary public Statement of affairs and lists to be annexed Statement as to the affairs of................... LLP (LLPIN .............. ), on the............day of.....20........., being the date of the petition or winding up order or order appointing Provisional Liquidator as the case may be showing assets at estimated realizable value and liabilities : (A) Assets I. Assets Book Estimated Due to Deficiency Estimated specifically value realizable secured ranking as Surplus mortgaged/pledged values creditors unsecured or having fixed and charge (excluding workmen floating charge) (as per list A ) Rs. Rs. Rs. Rs. Rs. Freehold Property Leasehold Property Plant Machinery Furniture, fittings, etc. Inventories Other assets ................... ................... Rs. II. Assets not specifically mortgaged/pledged, Book Value Estimated etc. (as per List B ) realisable values (Rs.) (Rs.) Balance at Bank Cash in hand Investments Debtors/Trade receivables Loans Advances Inventories Freehold Property Leasehold Property Plant Machinery Furniture, fittings, etc. Intangible Assets Other Assets (to specify) Outstanding contribution of the partners Gross Assets Rs. Gross realizable value of assets specifically mortgaged/pledged/having fixed charge _____________ Other assets _____________ Gross Assets _____________ B. Liabilities Gross Liabilities _____________ Secured creditors including workmen dues. _____________ Preferential creditors _____________ Creditors having floating charge _____________ Unsecured creditor and contingent liabilities _____________ Gross liabilities _____________ Rs. Estimated surplus from assets specifically mortgaged/ pledged/having fixed charge ___________ Assets which are not specifically Mortgaged/pledged, etc. ___________ Estimated total assets available for preferential creditors, creditors having floating charge and unsecured creditors ___________ Preferential creditors (as per List C ) ___________ Estimated balance of assets available for creditors having floating charge and unsecured creditors ___________ Creditors having floating charge (as per list D ) ___________ Estimated balance of assets available for unsecured creditors and unsecured balance of creditors partly secured on specific assets ___________ Unsecured Creditors, etc. (as per List E ) ___________ Estimated balance available to partners ___________ Claim of partners (as per List F ) ___________ Note :- Positive balance is treated as Surplus and negative balance is treated as Deficiency Signature Dated..............20.......... List A to the Statement of Affairs Schedule I Assets specifically mortgaged, pledged or having fixed charge (excluding floating charge) and creditors including workmen, fully or partly secured Particulars of Date when Estimated Name Amount Workmen assets security value of and of debt dues specifically given security address of mortgaged/ of secured pledged, etc., creditors creditors 1. 2. 3. 4. 5. 6. Proportion of Proportion of Balance of debt/ Estimated amount of amount of workmen dues surplus from secured workmen dues unsecured security creditors carried to List D 7. 8. 9. 10. Signature Dated..........20............ Schedule II Description of Assets Specifically mortgaged/pledged, etc. Assets Location Area Holder of the Amount address title the description person who is having the custody of the title deeds Freehold property Leasehold property Plant and machinery Furniture and fittings Inventories etc. Signature Dated..........20............ List B to the Statement of Affairs Schedule I Assets not specifically mortgaged/pledged, etc. II. Assets not specifically mortgaged/pledged,etc. Book Value Estimated realizable values (Rs.) (Rs.) Balance at Bank Cash in hand Investments Debtors/Trade receivables Loans Advances Inventories Freehold Property Leasehold Property Plant Machinery Furniture, fittings, etc. Intangible Assets Other Assets (to specify) Outstanding contribution of the partners Signature Dated..........20............ Schedule II Balance at Bank Name and address of the bank Bank balance Rs. Nature of the account (FD/SB/CA) Account No./ F.D. No. Person in whose custody the F.D. is lying Name and address of the officer of the LLP who operated the account Signature Dated..........20............ Schedule III Cash in Hand Amount Person in whose custody the cash is lying Person who was handling the cash in the LLP Signature Dated..........20............ Schedule IV Investments Nature of the investment Name of the body corporate/institutions where invested Date of investment Amount of investment Person in whose custody scrip(s) is/are lying Signature Dated..........20............ Schedule V Debtors/Trade Receivables (Including Bills of Exchange Promissory notes, etc.) Name and address and whether related to designated partner Amount Good or bad Within limitation or barred limitation When contacted and supporting documents Legal proceeding instituted (full details) Particulars of any securities held Cr. Bal. Signature Dated..........20............ Schedule VI Loans Advances Name and address and whether related to designated partner Amount Good or bad Within limitation or barred limitation When contacted and supporting documents Legal proceeding instituted (full details) Particulars of any securities held Signature Dated..........20............ Schedule VII Inventories Description Amount Quantity Location address Since when lying Signature Dated..........20............ Schedule VIII Description of other Assets Assets Location address description Area Holder of the title person in whose custody the title deeds are lying Amount Freehold property Leasehold property Plant and machinery Furniture and fittings, etc. Signature Dated..........20............ Schedule IX Outstanding Contribution of the Partners Name and address of the partner Amount outstanding Nature of the contribution Since when outstanding Any obligation Signature Dated..........20............ List C to the Statement of Affairs Preferential Creditors No. Name of creditor Address occupation Nature of claim Period during which claim accrued due Date when due Amount of claim Amount payable in full Balance not preferential carried to List D Signature Dated..........20............ List D to the Statement of Affairs Creditors having Floating Charge No. Name of Holder Address Amount Rs. Description of assets over which security extends Signature Dated..........20............ List E to the Statement of Affairs Unsecured Creditors, etc., No. Name Address Amount Date when contacted Document in support Consideration Unsecured creditors Unsecured balance of creditors partly secured brought from List A Balance not preferential creditors brought from List D Signature Dated..........20............ List F to the Statement of Affairs List of Partners Name address Amount of contribution Nature of contribution Since when the partner whether designated partner Amount of outstanding contribution Signature Dated..........20............ List G to Statement of Affairs Debt due from Partners No. Name Residential address Amount of Debts Details of documents in support When contracted and whether good or bad Particulars of any security held for debt Note: Contra entry shall be disclosed with full details. Signature Dated............20.....