LIST OF CLAIMS

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..... any class of creditors) 3 4 Unsecured financial creditors (other than financial creditors belonging to any class of creditors) 4 5 Operational creditors (Workmen) 5 6 Operational creditors (Employees) 6 7 Operational creditors (Government dues) 7 8 Operational creditors (other than Workmen, Employees and Government dues) 8 9 Other creditors, if any, (other than financial creditors and operational creditors) 9 Total [For Corporate Debtor] Signature Name of person submitting the information Relationship with corporate debtor OR [For Resolution Professional] Signature Name of Insolvency Professional Registration Number____ Annexure-1 Name of the corporate debtor: …………… Dat .....

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..... hellip;…… List of secured financial creditors (other than financial creditors belonging to any class of creditors) (Amount in ₹) Sl. No. Name of creditor Identification No. Details of claims Amount of contingent claim Amount of any mutual dues, that may be set- off Remarks, if any Amount of claim Nature of claim Amount covered by security interest Amount covered by guarantee Whether related party. % of voting share in committee I II III IV V VI VII VIII IX X XI XII 1 2 3 Annexure - 4 Name of the corporate debtor: …………… Date of commencement of PPIRP:………. List of creditors as on: ……………… .....

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..... laim Amount of any mutual dues, that may be set-off Remarks, if any Amount of claim Nature of claim Whether related party. % of voting share in committee, if applicable I II III IV V VI VII VIII IX X 1 2 3 Annexure - 7 Name of the corporate debtor: …………… Date of commencement of PPIRP:………. List of creditors as on: ……………………… List of operational creditors (Government dues) (Amount in₹) Sl. No Details of Government organisation Details of claims Amount of Amount of any mutual dues, that may be set-off Remarks, if any Department Government Identification Amount of claim Nature of Cla .....

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