PROOF OF CLAIM BY OPERATIONAL CREDITORS EXCEPT WORKMEN AND EMPLOYEES-Regulation 17 -Liquidation Process

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..... r] [Address as set out in the public announcement] From [Name and address of the operational creditor] Subject: Submission of proof of claim in respect of the liquidation of [name of corporate debtor] under the Insolvency and Bankruptcy Code, 2016. Madam/Sir, [Name of the operational creditor] hereby submits this proof of claim in respect of the liquidation of [name of c .....

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..... DETAILS OF HOW AND WHEN DEBT INCURRED 7. DETAILS OF ANY MUTUAL CREDIT, MUTUAL DEBTS, OR OTHER MUTUAL DEALINGS BETWEEN THE CORPORATE DEBTOR AND THE OPERATIONAL CREDITOR WHICH MAY BE SET-OFF AGAINST THE CLAIM 8. DETAILS OF ANY RETENTION OF TITLE IN RESPECT OF GOODS OR PROPERTIES TO WHICH THE DEBT REFERS OR .....

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..... Name in BLOCK LETTERS Position with or in relation to creditor Address of person signing *PAN, Passport, AADHAAR Card or the identity card issued by the Election Commission of India. AFFIDAVIT I, [name of deponent], currently residing at [address of deponent], do solemnly affirm and state as follows: 1. The above .....

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..... by my/our order, to my/our knowledge or belief, for my/ our 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 operational creditor which may be set-off against the claim.] Solemnly, affirmed at . . . . . . . . . . . on .....

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