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

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..... ereby submits this application to initiate a bankruptcy process in the case of [name of guarantor]. The details for the purpose of this application are set out below: Part - I PARTICULARS OF APPLICANT 1. Title and full name 2. Date of birth and e-mail address 3. Contact number(s) Home Mobile Business 4. Identification number of creditor Aadhaar number CIN PAN GSTIN 5. Address Present Permanent Business Part - II PARTICULARS OF THE GUARANTOR 1. Title and full name 2. Date of birth and e-mail address (to the extent known) 3. Any other name by which the guarantor is or has been known (as applicable) (to the extent known) 4. Address Present Permanent Business 5. Occupation/ Business/ Profe .....

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..... Any current or past position held in the corporate debtor (to the extent known) Identification number of the corporate debtor Whether corporate debtor is an associate (to the extent known) Any securities held in corporate debtor for whom guarantee is given 15. Where the guarantor is not a resident in India, the name and address of the person authorised to accept the service of process on guarantor's behalf, along with the authority Part-III PARTICULARS OF DEBT 1. Total debt (including any interest or penalties) 2. Amount in default 3. Date on which debt was due 4. Date on which default occurred 5. Nature of the debt 6. Secured debt including particulars of security held, the date of its creation, its .....

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..... __The application is only in respect of unsecured debt as per the details mentioned in serial number 7. 17. Statement by creditor in respect of excluded debts I [creditor] hereby state that the debt(s) for which the bankruptcy process application is filed does not include any- (i) liability to pay fine imposed by a court or tribunal; (ii) liability to pay damages for negligence, nuisance or breach of a statutory, contractual or other legal obligation; (iii) liability to pay maintenance to any person under any law for the time being in force; (iv) liability in relation to a student loan; (v) any other debt prescribed under section 79(15)(e) of the code. Part-IV PARTICULARS OF & DECLARATION BY INSOLVENCY PROFESSIONAL (IF P .....

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..... (vi) make the following disclosures in accordance with the code of conduct for insolvency professionals as set out in the Insolvency and Bankruptcy Board of India (Insolvency Professionals) Regulations, 2016 [insert disclosures, if any]. (Signature of the insolvency professional) Yours sincerely, Signature of creditor/ person authorised to act on behalf of the creditor [Please enclose the authorisation document if this application is being submitted on behalf of the creditor] Name in block letters Address of person signing List of documents to be attached to the application: 1. All records of the insolvency resolution process in respect of the guarantor, including the following- (i) Application for the insolvency resoluti .....

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