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Statement of affairs under section 454

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..... .......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 .....

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..... s 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 ........... .....

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..... 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 name .....

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..... 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 .....

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..... (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 ...... .....

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..... 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 sho .....

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