PROOF OF CLAIM BY A WORKMAN OR AN EMPLOYEE- Regulation 9- Insolvency Resolution Process for Corporate Persons

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..... aim in respect of the corporate insolvency resolution process in the case of [ name of corporate debtor ]. The details for the same are set out below: PARTICULARS 1. NAME OF WORKMAN/EMPLOYEE 2. PAN NUMBER, PASSPORT, THE IDENTITY CARD ISSUED BY THE ELECTION COMMISSION OF INDIA OR AADHAAR CARD OF WORKMAN / EMPLOYEE 3. ADDRESS AND EMAIL ADDRESS (IF ANY) OF WORKMAN / EMPLOYEE FOR CORRESPONDENCE 4. TOTAL AMOUNT OF CLAIM (INCLUDING ANY INTEREST AS AT THE INSOLVENCY COMMENCEMENT DATE) 5. DETAILS OF DOCUMENTS .....

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..... ..day of ..20 ., actually indebted to me in the sum of Rs. [ insert amount of claim ]. 2. In respect of my claim of the said sum or any part thereof, I have relied on the documents specified below: [ Please list the documents relied on as evidence of claim ]. 3. The said documents are true, valid and genuine to the best of my knowledge, information and belief and no material facts have been concealed therefrom. 4. In respect of the said sum or any part thereof, neither I, nor 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 betwe .....

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..... ebts, or other mutual dealings between the corporate debtor and the creditor which may be set-off against the claim.] Solemnly, affirmed at [ insert place ] on . . . . . day, the . . . . . day of . . . . 20 . . . Before me, Notary/Oath Commissioner Deponent's signature VERIFICATION I, the Deponent hereinabove, do hereby verify and affirm that the contents of paragraph . . . . . to . . . . of this affidavit are true and correct to my knowledge and belief and no material facts have been concealed therefrom. Verified at. . . . on this . . . . day of . . . . 201 . . . Deponent's signature - Forms Tax Management India - taxmanagementindia - taxmanagement - taxmanagementindia.com - TMI - TaxTMI - TMITax .....

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