Form No. 057 - Statement of affairs under section 454 - Company Court Rules, 1959

Form No. 57 (See rule 127) [Heading as in Form No. 1] Company Petition No. ................ of 19 .......... Statement of affairs under section 454 Statement of affairs of the above-named company as on the ................ day of ................ 19 .........., the date of the winding-up order [or the order appointing Provisional Liquidator or the date directed by the Official Liquidator.] I/We ................ of ................ do solemnly affirm and say that the statement made overleaf and the several lists hereunto annexed marked 'A' to 'I' are to be best of my/our knowledge and belief a full, true and complete statement as to the affairs of the above-named company, on the ................ day of ................ 19 .......... the date of the winding-up order [or the order appointing Provisional Liquidator or the date directed by the Official Liquidator], and that the said company carries/carried on the following business: Here set out nature of company's business] Signature(s) Solemnly affirmed at ................this ................ day of ................ 19 .......... Before me Commissioner for oaths The Commissioner is particularly requested, before swearing the affidavit, to ascertain that the full name, address and description of the deponent are stated, and to initial any crossings out or other alterations in the printed form. A deficiency in the affidavit in any of the above respects will entail its refusal by the court, and will necessitate its being re-sworn. Note. The several lists annexed are not exhibits to the affidavit. Statements of Affairs and Lists to be Annexed Statement as to the affairs of ............. Ltd., on the ................ day of .......... 19 ........., being the date of the winding up order (or order appointing Provisional Liquidator or the date directed by the Official Liquidator as the case may be) showing assets at estimated realisable values and liabilities expected to rank: Assets not specifically pledged (as per list 'A') Estimated realisable values Rs. Balance at Bank Cash in hand Marketable Securities Bills Receivable Trade Debtors Loans Advances Unpaid Calls Stock in trade Work in progress ........... ........... ........... ........... Freehold property, Land Buildings Leasehold property Plant Machinery Furniture, Fittings, Utensils, etc. Investments other than marketable securities Livestock Vehicles, etc. Other property, viz., ...................... ...................... @ Assets specifically pledged (as per list 'B') ( a ) Estimated realisable values ( b ) Due to secured creditors ( c ) Deficiency ranking as unsecured ( d ) Surplus carried to last column Rs. Rs. Rs. Rs. Free hold property: Rs. Estimated surplus from assets specifically pledged. Estimated total assets available for preferential creditors debenture holders secured by a floating charges, and unsecured creditors* carried forward Rs. Summary of Gross Assets ( d ) Gross realisable value of assets specifically pledged Rs. Other Assets Gross Assets Rs. @ Note. All assets specifically mortgaged, pledged or otherwise given as security should be included under this head. In the case of goods given as security, those in possession of the company and those not in possession should be set out. Estimated total assets available for preferential creditors, debenture holders secured by a floating charge and, unsecured creditors* (brought forward). Rs. ( e ) Liabilities Gross Liabilities Rs. (to be deducted from surplus or added to deficiency as the case may be). Secured creditors (as per List 'B') to extent to which claims are estimated to be covered by assets specifically pledged [item ( a ) or ( b ) on preceding page, whichever is the less]. ............. Insert in 'Gross Liabilities' column only) Preferential creditors (as per List 'C') ............. Estimated balance of assets available for Debenture Holders secured by a floating charge and unsecured creditors. Rs. Debenture Holders secured by a floating charge (as per List 'D') ............. Estimated Surplus/Deficiency as regards Debenture Holders Rs. ............. Unsecured Creditors (As per List 'E') Rs. Rs. Estimated unsecured balance of claims of creditors partly secured on specific assets, brought from preceding page ( c ) Trade Accounts Bills Payable Outstanding Expenses Contingent liabilities (state nature) .................................... Estimated Surplus/Deficiency as regards Creditors *[being difference between Gross Assets brought from preceding page ( d ) and Gross Liabilities as per column ( e )]. Rs. Issued and Called-up Capital: ........... preference shares of ........... each ........... Called-up (as per List 'F') ........... equity shares of ........... each ........... Called-up (as per List 'G') ........... ........... ........... ........... ........... ........... Estimated Surplus/Deficiency as regards Members* (as per List 'H') Rs. Rs. * These figures must be read subject to the following notes: (1) (f) there is no unpaid capital liable to be called up, or (g) the nominal amount of unpaid capital liable to be called up is Rs ............ estimated to produce Rs. ............... which is/is not charged in favour of Debenture Holders [Strike out (f) or (g)]. (2) The estimates are subject to costs of the winding-up and to any surplus or deficiency on trading pending realisation of assets. List 'A' Assets not specifically pledged Statement of Affairs: List 'A' Full particulars of every description of property not specifically pledged and not included in any other List are to be set forth in this list. Full statement and nature of property Book value Rs P. Estimated to produce Rs. P. State name of bankers. Balance at Bank Cash in hand Marketable Securities, viz ., ................................... Bills Receivable (as per Schedule I) Trade Debtors (as per Schedule II) Loans Advances (As per Schedule III) Unpaid Calls (As per Schedule IV) State nature Stock in Trade (as per Schedule V) State nature Work in progress Freehold property, viz ., ............................... Leaseshold property, viz ., ............................... Plant Machinery, viz ., ............................... Furniture, Fittings, utensils, etc., Patents, Trade Marks, etc., viz ., ............................... Investments other than Marketable Securities, viz., Livestock, Vehicles, etc. Other property, viz., ............................... Signature ............................... Dated ......... 19 ......... Schedule I Bills of Exchange, promissory Notes, etc., on hand available as Assets Statement of Affairs: Schedule I to List 'A' The names to be arranged in alphabetical order and numbered consecutively No. Name of Acceptor of bill or note Address, etc. Amount of bill or note Date when due Estimated to produce Particulars of any property held as security for payment of bill or note Rs. P. Rs. P. Signature ......................... Dated ............. 19 ....... Schedule II Trade Debtors Statement of Affairs: Schedule II to List 'A' The names to be arranged in alphabetical order and numbered consecutively Note. If the debtor to the company is also a creditor, but for a less amount than his indebtedness, the gross amount due to the company and the amount of the contra Account should be shown in the third column, and the balance only be inserted under the heading 'Amount of debt' thus: Rs. P. Due to the Company .............. Less Contra Account ................ No such claim should be included in List 'E' No. Name Residence occupation Amount of Debt Folio of ledger or other book where particulars to be found When contracted Estimated to produce Particulars of any securities held for debt Good Doubtful Bad Month Year Rs. P. Rs. P. Rs. P. Rs. P. Signature ........................ Dated ............ 19 ...... Schedule III Loans Advances Statement of Affairs: Schedule III to List 'A' Serial No. Date of advance Name Address of person to whom advanced: Amount due Estimated to realise Particulars of security, if any Folio of ledger or other book where particulars to be found Rs. P. Rs. Signature ..................... Dated ........... 19 ....... Schedule IV Unpaid Calls Statement of Affairs: Schedule IV to List 'A' The names to be arranged in alphabetical order and numbered consecutively Consecutive No. No. in share register Name of shareholder Address No. of shares held Amount of call per share unpaid Total amount due Estimated to realise Rs. P. Rs. P. Rs. Signature ................... Dated ......... 19 ....... Schedule V Stock in Trade Statement of Affairs: Schedule V to List 'A' Serial No. Description Quantity Book Value Estimated to realise Rs. P. Rs. Signature .................. Dated .......... 19 ....... Schedule VI Debts due from Contributories (Other than unpaid calls) Statement of Affairs: Schedule VI to List 'A' Consecutive No. No. in share register Name of shareholder Address Nature Particulars of the Debt Amount due Security held, if any, for the debt Serial No. in Schedule I, II or or III, as the case may be where the debt is included. Signature ................. Dated ......... 19 ..... List 'B' Assets specifically pledged and creditors fully or partly secured (Not including Debenture Holders secured by a floating charge) The names of the secured creditors are to be shown against the assets on which their claims are secured, numbered consecutively and arranged in alphabetical order as far as possible. Statement of Affairs: List 'B' Particulars of assets specifically pledged* Date when security given Estimated value of security No. Name of creditor Address occupation Amount of debt Date when contracted Consideration Balance of debt unsecured carried to Estimated surplus from security Rs. P. Rs. P. R P. Rs. P. Signature ........................ Dated ........... 19 ........ * All assets specifically mortgaged, pledged or otherwise given as security should be set out; goods given as security but in possession of the company and goods not in possession should be separately set out. List 'C' Preferential Creditors for Rates, Taxes, Salaries, Wages and Otherwise The names to be arranged in alphabetical order and numbered consecutively. Statement of Affairs: List 'C' 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 E' Signature ..................... Dated ........... 19 ........ List 'D' List of Debenture holders secured a floating charge The names to be arranged in alphabetical order and numbered consecutively. Separate Lists must be furnished of holders of each issue of Debenture, should more than one issue have been made. Statement of Affairs: List 'C' No. Name of Holder Address Amount Description of assets over which security extends Rs. P. Signature ...................... Dated .............. 19 ..... List 'E' Unsecured Creditors The names to be arranged in alphabetical order and numbered consecutively. Statement of Affairs: List 'E' Note . (1) When there is a contra-account against the creditor less than his claim against the company, the amount of the creditors claim and the amount of the contra-account should be shown in the third column and the balance only inserted under the heading 'Amount of Debt' thus: Total amount of claim Less: Contra-account Rs. P. No such set-off should be included in Schedule I attached to List 'A'. (2) The particulars of any Bills of Exchange and promissory Notes held by a creditor should be inserted immediately below the name and address of such creditor No. Name Address and Occupation Amount of Debt Date when contracted Folio of ledger or other book where particulars to be found Consideration Unsecured balance of creditors partly secured Rs. P. Month Year brought from List 'B'. Balance not preferential of preferential creditors brought from List 'C' Signature ........................ Dated .............. 19 ...... List 'F' Preference Shareholders The names to be arranged in alphabetical order and numbered consecutively Statement of Affairs: List 'F' Consecutive number Register number Name of shareholder Address Nominal amount of share Number of shares held Amount per share called up Total amount called up Rs. P. Rs. P. Signature ................. Dated ............. 19 ...... List 'G' List of Equity shareholders The names to be arranged in alphabetical order and numbered consecutively Statement of Affairs: List 'G' Consecutive number Register number Name of shareholder Address Nominal amount of share Number of shares held Amount per share called up Total amount called up Rs. P. Rs. P. Signature ................. Dated ............. 19 ...... List 'H' Deficiency or surplus Account Statement of Affairs: List 'H' The period covered by this Account must commence on a date not less than 3 years before the date of the winding-up order [or the order appointing Provisional Liquidator, or the date directed by the Official Liquidator] or, if the company has not been incorporated for the whole of that period, the date of formation of the company, unless the Official Liquidator otherwise agrees. Items contributing to deficiency ( or Reducing Surplus ): 1. Excess (if any) of Capital and Liabilities over Assets on the ................. 19 ........... as shown by Balance Sheet (copy annexed) Rs. 2. Net dividends and bonuses declared during the period from ........... 19 ........... to the date of the statement 3. Net trading losses (after charging items shown in note below) for the same period 4. Losses other than trading losses written off or for which provision has been made in the books during the same period (give particulars or annex Schedule) 5. Estimated losses now written of or for which provision has been made for the purposes of preparing the statement (give particulars or annex Schedule) 6. Other items contributing to Deficiency or reducing Surplus: Rs. .................................................................. .................... Items reducing Deficiency ( or contributing to Surplus ): .................... Rs. 7. Excess (if any) of assets over capital and liabilities on the ................ 19 ......... as shown on the Balance sheet (copy annexed) 8. Net trading profits (after charging items shown in note below) for the period from the ................. 19 .......... to the date of Statement 9. Profits and income other than trading profits during the same period (give particulars or annex Schedule) 10. Other items reducing Deficiency or contributing to Surplus: ................................................................. Deficiency/Surplus as shown by Statement Rs. Note as to Net Trading Profits and Losses: Particulars are to be inserted here (so far as applicable) of the items mentioned below, which are to be taken into account in arriving at the amount of net trading profits or losses shown in this account: Provisions for depreciation, renewals, or diminution in value of fixed assets Charges for Indian Income-tax and other Indian taxation on profits Interest on debentures and other fixed loans Payments to directors made by the company and required by law to be disclosed in the accounts Exceptional or non-recurring expenditure: Rs. ................................................................. Rs. .................... Less Exceptional or non-recurring receipts: ............................................................ Rs. .................... Balance being other trading profits or losses Rs. .................... Net trading profits or losses as shown Deficiency or Surplus Account above Rs. .................... Signature .................... Dated ................ 19 .... List 'I' Statement of Affairs: List 'I' In substitution for such of the list 'A' to 'H' as will have to be returned blank. List Particulars Remarks Where no entries are made on any one, or more of the Lists 'A' to 'H' the word 'Nil' should be inserted in this column opposite to the list or Lists thus left blank. A Assets not specifically pledged B Assets specifically pledged and creditors fully or partly secured (not including debenture holders secured by a floating charge) C Preferential creditors for Rates, Taxes, Salaries, Wages and otherwise D Debenture holders secured by floating charge E Unsecured creditors F Preference shareholders G Equity shareholders H Deficiency or Surplus Account Signature ................. Dated ............... 19 .......