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APPLICATION BY GUARANTOR TO INITIATE BANKRUPTCY PROCESS - Application to Adjudicating Authority for Bankruptcy Process

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..... birth and e-mail address 3. Any other name by which the debtor is or has been known (as applicable) 4. Address (i) Present (ii) Permanent (iii) Business 5. Occupation/ Business/ Profession 6. Annual income in the preceding year (in Rupees) 7. List of associates of the guarantor , including relatives, who may be creditors Name Age Address 8. Bank account details (Joint and Several) Account number IFSC code Name of Branch and Branch address .....

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..... Any other movable property 12. Number of directorships held in the last three years (along with name of company in which directorship is held and Directors Identification Number) and CIN of such companies 13. Marital status (single, married, divorced, widowed, co-habiting, separated, or specify any other) 14. Details regarding guarantee given by guarantor (in addition to information in serial number 1-13 of this part) Name of corporate debtor for which guarantee is given Any current or past position held in the corporate debtor Identification number of the corporate debtor Whether corporate debtor is an a .....

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..... Whether employees to whom debt owed (state yes or no, and if yes, details to be mentioned in Part III) Part - III PARTICULARS OF DEBT [CREDITOR WISE, AS APPLICABLE] 1. Name(s) of creditor(s) 2. Address Present Permanent Business 3. Total debt (including any interest or penalties) 4. Amount of debt in default 5. Interest or penalties, if any 6. Date when the debt was due 7. Date when the default occurred .....

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..... Mobile Business 5. Declaration by insolvency professional I, [ name of insolvency professional ], an insolvency professional registered with [ name of insolvency professional agency ] having registration number [ registration number ] have been proposed as the insolvency professional by [ name of applicant guarantor ] in connection with the proposed bankruptcy process of [ name of the guarantor]. I hereby: (i) agree to accept appointment as the insolvency professional if an order of appointment is passed by the Adjudicating Authority; (ii) state that the registration number allotted to me by the Board is [ insert registration number ] and that I am currently qualified to practice as an insolvency professional; (iii) disclose that I am currently serving as an insolvency professional / resolution professional / liquidator/ bankruptcy trustee in [ insert number and details of the proceedings ]; (iv) certify that there are no disciplinar .....

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..... ng / rejecting the application under serial number (i) above under section 100 of the Code, as the case may be; (b) approving / rejecting the repayment plan under section 114 of the Code, as the case may be; (c) declaring that the repayment plan has not been fully implemented under section 118 and entitling the debtor to apply for bankruptcy, as the case may be; (d) any other order that may have been passed by the Adjudicating Authority in relation to the insolvency resolution process. 2. All documents mentioned in serial number 13 of Part III of this form. 3. Copy of the income tax returns with detailed computation of the income of the guarantor, or the firm, as the case may be, for the previous three years. 4. Copy of the personal guarantee contract. 5. Copies of entries in a bankers book in accordance with the Bankers Books Evidence Act, 1891 (18 of 1891) 6. The latest and complete copy of the financial contract reflecting all amendments and waivers to date. 7. Copies of relevant ownership and title documents for all assets. 8. Copy of the authorisation, wherever required under .....

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