CLAIM WITH PROOF BY A CREDITOR - Insolvency Resolution Process for Personal Guarantors to Corporate Debtors

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..... oof in respect of the resolution process of [ name of guarantor ]. The details for the same are set out below: 1. Title and full name of creditor 2. Identification number of creditor Aadhaar Number PAN CIN GSTIN 3. Address Present Permanent Business .....

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..... f any security held (including value and date when it was given) 13. If you are a secured creditor, tick the applicable box in the right column relating to forfeiture of right to enforce security during the period of the repayment plan, which will determine the voting share as per section 110 of the Code □ I agree to forfeit my right to enforce my security [insert description] during the period of the repayment plan. □ I do not agree to forfeit my right to enforce my security [insert description] during the period of the repayment plan. 14. (i) Amount cla .....

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..... spect of my claim of the said sum or any part thereof, I have relied on the following documents: (a) (b) (c) (d) . . . 3. The aforesaid documents are true, valid and genuine to the best of my knowledge, information and belief. 4. In respect of the said sum or any part thereof, I have not, nor has 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 between the guarantor and the creditor which may be set-off against the claim .] Date: Pl .....

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