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PROOF OF CLAIM SUBMITTED BY AUTHORISED REPRESENTATIVE OF WORKMEN AND EMPLOYEES- Regulation 9 -Fast Track Insolvency Resolution Process for Corporate Persons

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..... ocess for Corporate Persons ) Regulations, 2017 ) [ Date ] To The Interim Resolution Professional / Resolution Professional, [ Name of the Insolvency Resolution Professional / Resolution Professional ] [ Address as set out in public announcement ] From [ Name and address of the duly authorised representative of the workmen / employees ] Subject: Submission of proofs of c .....

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..... corporate debtor in respect of services rendered by them respectively to the corporate debtor during such periods as are set out against their respective names in the said Annexure A. 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 .....

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..... e record of pendency of suit or arbitration proceedings (if any). 3. Particulars of any mutual credit, mutual debts, or other mutual dealings between the corporate debtor and the creditor which may be set-off against the claim. ATTACHMENTS : (a) Documents relied as evidence as proof of debt and as proofs of non-payment of debt. (b) Affidavit in the form set out in this Form E. AFF .....

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..... hereof, 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 debtor and the creditor which may be set-off against the claim.] Solemnly, affirmed at [ insert p .....

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