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

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..... 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) .....

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..... r not Vehicles Shares in listed companies Shares in other companies Life insurance policy Jewelry Pension policy Investment in mutual funds Investment in other funds Investment in partnerships and other b .....

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..... 6. Secured debt including particulars of security held, the date of its creation, its estimated value as per the creditor (as applicable) 7. Unsecured debt (as applicable) 8. Details of retention of title arrangements (if any) in respect of goods to which the debt refers (attach a copy) 9. Details of any mutual credit, mutual debts, or other mutual dealings between the guarantor and the creditor, which may be set-off against the claim (attach proof) 10. Particulars of an order of a court, tribunal or arbitral panel adjudicating on the default, if any (attach a copy of the order) 11. Record of default with the information utility, if any (attach a copy) 12. Details of succession cer .....

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..... Permanent Business 3. E-mail address(es) 4. Contact number Home 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 pr .....

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