FORM NO. CHG-l App licati on for registration of creati on , modi fi cation of charge (other than those related to debentures) including particulars of modification of charge by Asset Reconstruction Company in terms of Securitization and Reconstruction of Financial Assets and Enforcement of

Interest Act, 2002

[Pursuant to sections 77,78 and 79 and pursuant to Section 384 read with 77,78 and 79 of the Companies Act, 2013 and Rule 3_ of the Companies (Registration of Charges ) Rules 2014]

Form Language 0 English 0 Hindi Refer the instruction kit for filing the form.

1. (a) *Corpo r ate identi ty numbe r (CIN) or foreign compa ny 1 registrati on number (FCRN) of the company L- ---I

(b) Global Location Number (GLN) of company

Pre-fill

2. (a) Name of the compan y

(b) Address of the regis t ered office or principal place of business in India of the compan y

(c) email id of the compa ny I ~----------------------------------------------------------------------------------------------------~

3. (a) *This form is for regi strati on of o Creation of charge 0 Modi fication of charge

(b) Charge ID of the charge to be modified 1.--=------------. 4. *Whether the appli cant is 0 The company 0 The charge holde r

5. (a) *Date of the instrumen t creating or modifying the charge (b) *Nature, descripti on and brie f parti culars of the instr ument( s) creating or modi fying the charge

(c) *Whether char ge is crea ted or modi fied outside India 0 Yes 0 No

6. (a) Whethe r charge is modi fied in favour of asset recon stru cti on company (ARC) or assignee 0 Yes 0 No

(b) Whether char ge holder is authorised to assign the charge as per the charge agreeme nt 0 Yes 0 No

7. Type of charge

<(a) A charge on

Uncall ed share capital Calls made but not paid Immova ble prop erty or any interest therein

Movable proper ty Floating charge Motor Vehicle (Hypotheca tion)

Patent Any property for secur ing the issue of secur ed deposits

Licence unde r a patent

Goodwill

Trade mark Copyright

Book debts Ship or any share in a ship Solely of Property situated

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outside India

Others

(b) If others, speci fy ,..---------------------------------,

8. (a) "'Whether conso rtiu m finance is involved 0 Yes 0 No If yes, enter Lead Banker's name ,..---------------------------,

(b) "'Whether joint charge is involved 0 Yes 0 No

(c) =Nurnber of charge holder( s)

(d) Whether charges rank pari passu 0 Yes 0 No Ranks of the charge holde r (s)

Rank Charge holder

(Note: Please attach a complete list of charge holders, details of their extent to the charge, particulars of property charged, amount secured etc.)

9. Particulars of the charge holder (in case charge is modi fied in favour of ARC or assignee, enter the particulars of ARC or assignee)

Category

If others, speci fy

Get List of Charge holders

Name

In case of others, specify

CIN, if applic

=Narne

*City

*State

Country

able I I [_ y re - fill I _j

ne I I ell I

I *ISO country code I

Address *Li Lin

*Pin code

••• e-mail id

*Whether charge holder is having a valid Income Tax PAN 0 Yes 0 No Income tax-Permanent Account Number (PAN) BSR Code / Branch Code Ir---------'----,t --------__J

10. (a) =Arnount secured by the charge (in Rs.) (In case the amount is in foreign currency, rupee equivalent to be stated) (In case of modi ficati on/ rectification of charge, enter the amount secured by the charge after such modification)

(b) Amount secured by the charge in words

(c) In case amount secured by the charge is in foreign currency, mention de tai ls

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1,1. Brief particulars of the principal terms and cond iti ons and extent and operation of the charge

(a) Date of Creating Securi ty Interest by actual/ constructi ve deposit of title deeds within bank/ housing finance company I I

(DD/MM /VYYY)

(b) Borrower's customer/account number

(c) *Rate of interest

(d) Repayment term (in months)

(e) *Terms of Repayment

(f) Nature of facility

(g) Date of Disbursemen t

(h) Miscellaneous narrati ve informati on

(i) *Margin

I ._ ----ll (DD/MM/VYYY)

(j) *Extent and operation of the charge

(k) Others

, 12. In case of acquisiti on of property, subjected to charge, furnish the details relati ng to the existing charge on the property so acquired

(a) Date of instrument crea ting or evidenci ng the charge , J ~------------------~ (b) Descripti on of the instrument crea ting or evidencing the charge

(c) Date of acquisi ti on of the property ':===========:' (d) Amount of the charge (in Rs.) I I ~----------------~ (e) Particulars of the prop erty charged

13. *Short particulars of the property or asset( s) charged (including complete address and location of the property)

o Plot Unit 0 Dwelling Interest

Evaluated Price of Nature of Property Asset as on Security interest Creation date

PLOT ID Numbe r Survey No. /Gat No. etc. *

Street Numbe r & Name Sector /Block Number Local it y Landmark

Village / Town Name Taluka District State

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Pin Code *Latitude *Longitude Area of plot (Sq. feet, Sq. meter, Acre, Gunta, Cents, Hectares)

Evaluated Price of Nature of Property PLOT 10 Number Su rvey No. /Gat No. * Asset as on Security interes t Creation date

Dwelling Unit 10 Floor No. Building Name & Street Name / No. Number Society Name

Sector /Block Number Loc ality Landmark Village/Town Name

Taluka Dis trict S tate Pin Code

*Lati tude *Longitude Area of dwelling (Sq. feet, Sq. Meter)

Bounded by

By North By South By Eas t By West

'Survey number, GAT number, Khesra number; khweta number, Mouza number, Phase number or any other such similar representation in various states or union territories can be captured in this field.

(All the fields should be captured as appearing in the revenue record, flat no, house no, Municipal OfficefMunicipal Corporation / Grampanchayat are to be specified and also the area of the immovable property as well as boundar ies)

14. Desc ription of document by which the borrowe r/thi rd par ty acquire title

Number of title documents deposited by customer

Documen t type

Document Number

Sub-regis trar

Taluka

District

State

Country Code

Pin Code

15. (a) *Whe ther any of the property or in teres t therein under reference is not registered in the name of the company 0 Yes 0 No

(b) If yes, name of the person in whose name it is registered

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16. *Date of creation/last modifi cation prior to the prese nt modificati on

17. Parti culars of the prese nt modi ficati on (please ensu re that the co rr ect particulars are entered as the same shall be displayed in the certificate of modificati on of charge)

List of attachments Attachme nt s (1) *Instrument( s) of creati on or modifica t ion of charge; I (2) Instrumen t(s) evidencing creation or modi ficati on of charge in

case of acquisiti on of property which is alre ady subject to charge . together with the instrumen t evidencing such acquisi tions;

(3) Particulars of all joint char ge holders; (4) Optional attachments, if any ' - ;::==- == -- =====::::; -'

Remove Attachment

Declara t ion I am authori zed by the Board of Directors of the Company vide resoluti on number * L- -l *dated

to sign this form and declare that all the requi rements of Compani es Ac t, 2013 and the rules made thereund er in respect of the subje ct matter of this form and ma t ters incidental thereto have been compli ed with. I also declare that all the information given herein above is true, cor rect and comp lete and as per the attached charge instrument(s) or document(s) and nothing ma teri al has been suppressed. A copy of the attached charge instrumen t (s) or documen t(s) is/ are avai lable at the registered office or principal place of business in India of the company.

o I further declare that: (a) the delay in filing the particulars of creation /modi fi cation, was accidental or due to inadvertence or some

other sufficient cause and are or is not of a nature to prejudi ce the posi tion of the charge holder, shareholders or creditors of the company;

(b) no prejudice would be caused to the charge holder(s) or any other credi tor(s) of the company, if the delay is condoned;

(c) the company has not created or modifi ed any other charge (s) whatsoever on the assets of the company, since the creati on / modi ficati on of the prese nt charge, for which the applicati on for condonation of delay is being filed;

(d) the company is carrying on the bus iness as on the date of filing this applica t ion and no proceedi ngs to wind- up the compa ny have commenc ed or are pendi ng aga inst the company;

(e) there is no litigation proceedings pend ing before any court of law for which condonation of dela y is being filed;

(f) the company has not applied for striking off the name of the company from the registe r of Registrar of Compani es

To be digi tally signed by

Director or manag er or secreta r y or CEO or CFO (In case of an Indian company) or an authorised representa t ive (In case of a foreign company)

DSC Box

Designa tion

DIN of the director; PAN of the manager or CEO or CFO or representative; or membership number of company secr etary

Declaration I/we confirm that the attached charge instrument(s) or document(s) is/are true copies of the orig inal which is/are avai lable with the charge holder and / or assignee and all the information and par t iculars mentioned above are derived there from are conci sely and correctly stated. I/we am / are duly authorised to sign this form. I/we am/are a multilateral/Internati onal financial institu ti on who has/have been exemp ted from payment of

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income tax in India unde r the UN Privileges and Immuni ties Act.

To be dig it ally signed by DSC Box

Charge Holder PAN of the charge holder

To be digi tall y signed by DSC Box

ARC or assignee PAN of the ARC or assignee

Certi ficate by practi cin g professi onal I declare that I have been duly engaged for the purpose of certi fication of this form. It is hereby certified that I have gone through the provisions of the Compani es Act, 2013 and rules thereunder for the subject matter of this form and matters incidental thereto and I have verified the above particulars (including a ttachmen t(s)) from the original/certified records maintained by the Company / applicant which is subject matter of this form and found them to be true, correct and complete and no information material to this form has been suppressed. I further certify that:

i. The said records have been properly prepared, signed by the required officers of the Company and maintained as per the releva nt provisions of the Companies Act, 2013 and were found to be in order;

ii. All the required attachments have been completely and legibly attached to this form. To be digitally signed by I

DSC Box ~ -- --,-,-- _ __J.

o Chartered accountant (in whole-time practice); or o Cos t accountant (in whole-time practice ); or o Company secretary (in whole-ti me practice)

Whether associate or fellow 0 Associate 0 Fellow Membership number ~--------------~ Cer tifi cate of Practice number

Note: Attentio n is also drawn to provi sions of Section 447 , section 448 and 449 of the Compani es Act, 2013 which provi de for puni shment for fraud, pun ish ment for false statement and punishment for false evidence respectively.

Prescrutiny Check Form

=1 =========1 (0 IMMIYYYY)

For 0 fice use only:

eForm Service request number (SRN)

Digital signature of the authorising officer This e-Form is hereby regis ered

Date of signing (DD/Ml'vl,YYYY)

OR This eForm has been taken on file maintained by the registrar of companies through electronic mode and on the basis of statement of correctne ss given by the filing company

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FORM NO. CHG-8 ~~~ r>- Applic ation to Central Government for ~~ extensi on of time for filing particular s of

,t regi st r ati on of satisfaction of charge OR I I

I:i~ i,~ for rectification of omission or I fPu rs uant to sec t ion 77(1 ) read w it h 87 U ! pf The Compan i es Act , 2013 and ru l e 12 8.1 misstatement of any particular in respect .6~; r" . . , of The Com pan i es ( Reg i strat i on of of cr eation / modifi cation/ satisfaction of [ I cha rges ) Ru l es 2014 ] ~('= qi'l"1 ~ charge

I Fo rm Language 0 Eng lish 0 Hind i i i Refer the ins truc ti on kit for filing the form. ; ; 1. (a) =Corporate identity numb er (CIN) or foreign company I I j registration numbe r (FCRN) of the company ~ _l:i _II _J

( (b) Global Location Numbe r (GLN) of company I I I ~. (a) Name of the company I I (b) Address of the registerJd off ice or pi rrr rr pat place of tnrsrrres s ill flldia of tile compa rrv ,

" : , j , ! I ! (c) email 10 of the company I > !

i 3. *This form is for condonation v, I : ? Delay in registration of

Satisfaction of Charge

- Omission or misstatement of any particular in respect of

Creation of Charge Modification of Charge

... -." Satisfaction of Charge

, 4. *The application is made by 0 Compan y o Any other interested person

\ 5. *SRN of relevant form o Form CHG-l o Form CHG-4 0 Form CHG-9 I I 1 6 •. Charge identifi cation number(ID) I I 7. (a) *Date of creation /modi fication/sati sfacti on of char ge entered in the relevant form I I

, '(b) *Amount of charge created/modified/sati sfied I I : (c) *Name(s) of the charge holder(s) I I i

i (d) *Particulars of the property or asset(s) charg ed (including complete address and location or the property)

'"

il ( ( " 8. *Reasons for delay/omission/misstatement in filing

I , i r ;

9.' =Detalls of omissi on/mi sstatement and the relief required

; : f ,

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s

" ~I Attachment (s )

1. *Ins t rume nt creating/modifying/sati sfyi ng the charge; 2. Letter of authorisati on (in c~se of Au t hori sed

List of attachments

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t 6t t,.,.. h •.•.•• n. At t, . ,..h •.•.•• nt ]

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- - - A": I, . h,,"ont

[ 6ttla , . hrn",nt [_ Remove attach ~ en t

I

i[ Declaration (if applicant is any person other than the compan y) l- I . confirm tha t the delay in filing the particula rs of creation /modifi cati on/sati sfaction or omission or missta t ement, was ! accidental or due to inadvertence or some other sufficient cause and are or is not of a nature to prejudi ce the posi tion of the \1 arge holder, shareholders or creditors of the comp any and all the informati on and particulars mentio ned above are concisely ~{ " .d cor r ectly sta ted. ! .. :~~ .....................................................................................................•

Represen tati ve of a foreign company ); I 3. Copy of resoluti on of the Board authori sing the filing ~ of the applicati on and appointing the authorized i representative, if any; ,,' 4. Aff i davit; ! 5. Confi rmati on from the Charge-holder;

6., Balance Sheet and Annual Return of financial year in which form was filed for which recti ficati on is done (if

II 7. c~~~~~:~~t; tachmen t, (if any) ~<

j. 1 , Decl ar ati o n (if applic ant is company)

do solemnly decla re that I am the (Drop down: values - director or manager or company secr etary or CtO or CFO or an authori sed representati ve); and it is further declared that 1. the delay in filing the particulars of satis fac t ion or omission or misstatement of any particulars with respect to

crea tion /modifi cati on/satisfactio n, was accidental or due to inadver tence or some othe r suff icient cause and are or is not of a nature to prejudice the posi ti on of the char ge holder, shareholde rs or credi tors of the company;

2. no prejudi ce would be caused to the charge holder( s) or any other credi tor(s) of the company, if the delay is condoned or omission or missta t ement is rec t ified;

3. the company has not created or modified any othe r charge(s) whatsoever on the assets of the company, since the crea ti on / modi fication of the prese nt charge, for which the application for condonati on of delay is being filed;

4. the company is carrying on the business as on the date of filing this applicati on and no proceedin gs to wind-up the company have commenced or are pending against the company;

5. there is no litigation proceedings is pending before any court of law for which condon ati on of delay is being filed; 6. the company has not applied for striking off the name of the company from the Register of

i ' Registrar of Companies.

It ,,'c be digi ta lly signe d by t

DSC ~ Director or manage r or compan y secre ta ry or CEO or CFO (In case of an Indian co npany) or an authori sed representati ve (In case of a foreign company)

I : Designati on 1 1

,I DIN of the director; or DIN or PAN of the manager or CEO or CFO or 1 •..... ---'1 !I or authorised represen t ative; or Membership number of the company secretary ,I •

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to be digi tally signed by ! !- , ! Charge Holder 1 'PAN ,.. .-------------, I

DSC

! To be digitan y signed by

It ARC or a~signee \ !' PAN .-------------,

i T~ be digitally signed byi,-- __ D_S_C _---' ., b~signati on ~ , I .---========~------------------~ , PAN

" '""'.- ;

I' Note: Attention is also drawn to provisions of Sec t ion 44 7, section 448 and 449 of the Companies Act, 2013 !I which provide for punishment for fraud , punishment for false statement and punishment for false evidence (' respectively

f,' I, ~ , ~ .

DSC

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If,' MCA21 \ . H 'I' u..--

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FORM NO. CHG-9 ~~ Appli cation for registration of

[Pursuan t to sections 71(3 ), 77, 78 ~-[ creati on or modification of & 79 and pursuant to Section 384 charge for debentures or read with 71( 3) , 77, 78 and 79 of rectifi cation of particul ars The Companies Act , 2013 and Rule 3 ~ [._'.', 1: ~:~ filed in respect of creation or of The Compani es (Registrat ion of

't1<:"" ..••• qq ~ modification of charge for Charges ) Rules, 2014 ] debentures

For m Language 0 English 0 Hind i Refer the instructi on kit for filing the fo rm.

l - - - - - _~I I 1.(a ) Cor porate identi t y num ber (CIN ) or foreign com pan y Pre- fill regi st ra t ion number (FC RN ) of th e compan y -- -

(b) Global location num ber (GLN ) of com pan y I I 2.(a) Nam e of the co m pany

(b ) Addr ess of th e regis t ered off i ce or of the pri nci p al place of business in Indi a of the company

(c ) e-mail 10 of the company

3. (a) *This form is for o Creation of charge o Modification of charge o Rectifi cation of charge (b) *Type of debentures o Debe ntures o Debe nture Stoc k o Bond o Any other instrument (c) SRN of the form for which recti fication is being filed I I (d) Charge 10 of the charge to be modified or rectified I I (e) SRN of form INC-28 j I (f) Rectificati on to be mae In regard to

o Type of debentures o Number of trustees or debenture holders

o Particulars related to series of debentures o Particulars related to present issue of series

o Amount secured by charge o Descri ption / Particulars of property charged

o Principal terms and condi tions, extent and oper ation of charge o Extent of charge

o Particulars of commissions, allowances or discount

4. (a) *Whether the applicant is o Compan y o Trustee of debentu re holde rs or charge holder

(

5, *Number of trustee(s) of debentur eholders or chargeho lder(s) I I Particulars of the trustee of debentur e holders or charge holde r (in case charge is modified in favour of ARC or assignee, enter the parti culars of ARC or assignee)1

Get List of Charge holders I Name

I I In case of others, speCify CIN, if applicable I I I Pre - fill I

www.taxguru.in

I'lame I I Address "'Line I I I

Line II I I -cuv I I

I "'State I I

I "'ISO country code I I I

I '" Country I I "'Pin code I I *e-mail id I I

"'Whether trustee of debenture holder or charge holder is having a valid Income Tax PAN DYes o No Income tax-Permanent Account Number (PAN) I I BSR Code / Branch Code I I

I 6. Date of creation of charge I I (DD/MMIYYYY) I I 7. Whether the charge is for 0 Entire series of debentures 0 Any issue in a series of debentures

I I 8.(a) Whether the series of debentures are registered with the Registrar of Companies (RoC) 0 Yes 0 No I

l (b) If yes, (i) The total amount secured by the whole series (in Rs.) I I I (ii) Date of registration of series I I (DD/MMIYYY V)

I 9. (a) "Date of present issue of series, I I (DD/MMIYYYY)

(b) "Amount of present issue of series (amount secured by the charge) (in Rs.) I I I (In case of modification of charge, enter the amount secured by the charge after such modification) I

I (c) Amount secured by the charge in words I , i I I I i

10. Date of resolution authorising the issue of the series I I (DD/MMIYYYY)

I 11.(a) "Description of the property charged indicating whether it is a charge on

Uncalled share capital Calls made but not Immovable property or any paid interest therein

Movable property Floating charge Motor Vehicle (Hypothecation)

Any property for securing Goodwill Patent the issue of secured deposits

I Licence under a pa tent Trade mark Copyright

I Book debts Ship or any share in a Solely of Property situated ship outside India

Others

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(b) If others, specify

(c) *Par ticulars of the property charged (including location of the prope rt y)

o Plo t Unit 0 Dwelling Interest

Evaluated Price of Nature of Proper t y Plot 10 numbe r Surve y number /Ga te Asset as on Securi ty numbe r etc. * interest Creation date

Street Numbe r and Sector /Block Number Locality Landma r k . Name

Village / Town Taluka District State

Pin Code *Lati tude *Longi tude Area of plot (Square feet/meter, Acre, Gunta, Cents, Hectares)

I Evalua t ed Price of Nature of Property Plot 10 number Survey number/Gate Asset as on Securi ty numbe r * interest Creation date

Dwelling Unit 10 Floo r number Building Name and S tree t number and Number Socie ty Name name

Sector/Block Number Locali ty Landmar k Village / Town Name

I Taluka Dis trict Sta te Pin Code

*Latitude *Long it ude Area of dwelling (Square feet /me t er)

Bounded by

I By North By Sou th By East By Wes t

"Survey number, GAT number, Khesra number; khweta number, Mouza number, Phase number or any other sueh similar representation in various states or union territories can be captured in this field.

(All the fields should be captured as appearing in the revenue record, flat no, house no, Municipal Office lMunicipal Corporation / I Gram panchayat are to be specified and also the area of the immovable property as well as boundaries)

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12 .• Brief of the principal terms and conditions, (includ ing rate of interest, dat e of redemp tio n and creati on of

debe nture redemp tio n reserve) extent and opera ti on of charg e

(a) Date of Creating Securi ty Interest by actual! constr ucti ve deposi t of title deeds within bank/ housi ng finance company I I

(DD/MM/YVYY)

(b) Bor r ower' s customer / account numbe r

(c) *Rate of interest

(d) Repayment term (in month s)

(e) *Terms of Repayment

(f) Natu r e of facility

(g) Date of Disburseme nt

(h) Miscellaneous narrativ e information

(i) *Margi n

L..I ___.I (DD/MM/YVYY )

(j) *Ex ten t and operation of the cha r ge

(k) Others

13 .• Particulars as to amount or rate percent of the commission, allowances or discount (if any) paid, or made

either directly or indirectly by the company to any person(s) in consideration of their subscribing or agreeing te subscribe, whether absolutely or conditionally, or procuring or agreeing to procure subscriptions, whether absc lut e or conditional, for any of the debentures included in this return.

Modific ati on of charge

14.(a) 'Whethe r char ge is modi fie d in favo ur of asset recons tructi on company( ARC) or assig nee 0 Yes 0 N

(b) Whethe r trust ee of debent ure holders or char ge holde r is authorised to assign the char ge 0 Yes 0 N

1S.(a) 'Description of the instrument modifyin g the char ge

(DD /MM lY YYY) (b) 'Dat e of instrume nt modi fyin g the char ge I I

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16. 'Particulars of the present modificati on (Please ensure that correct particulars are enter ed as the same shall be displayed in the certificate of modificatic n f charge)

17. Description of the document by which the company acquired the title

Number of title documents deposi ted by customer IL.._ ---II I Document type

Document Numbe r

Sub-regi strar

Taluka

District

State

Country code

Pin Code

List of Attachment(s) attachments I I At tachment (1) Copy of resoluti on authorising the issue of debenture series; ~======~ (2) Attachment

I Remove attachment

*Instrument(s) of creation or modification of charge;

(3) Order of the Central Government for rectification of charge;

(4) Optional attachments, if any

Attachment

Attachment

Decla r atio n I am authorized by the Board of Directo rs of the Company vide reso lution number *1 1 dated *1 I to sign this form and declare that all the requirements of Companies Act, 2013 and the rules made ther eunder in respect of the subject matter of this form and matters incidental thereto have been compli ed with. I also decla re that all the informati on given herein above is true, correct and complete and as per the attached charge instrumen t(s) or document(s) and nothing material has been supp ressed. A copy of the attached charge instrum ent(s) or document(s) is/ are available at the registered office or principal place of business in India of the company.

o I further declare that: (a) the delay in filing the particulars of creation/modi fication, was accidental or due to inad ver tence or

some other sufficient cause and are or is not of a nature to prejudice the posi ti on of the charge holder, shareholders or credi tors of the company;

(b) no prejudice would be caused to the charge holder(s) or any other credito r(s) of the comp any, if the delay is condoned;

(c) the company has not created or modi fied any other charge(s) whatsoever on the assets of the company, since the creation / modi ficati on of the present charge, for which the application for condonation of delay is being filed;

(d) the company is carrying on the business as on the date of filing this application and no proceedi ngs to wind-up the company have commenced or are pending against the company;

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(e) there is no li tiga tion proceedings pending before any court of law for which condonation of delay is being filed;

(f) the compa ny has not applied for striking off the name of the company from the register of Registra r of Companies

To be digitally signed by Direc to r or manag er or secreta ry or CEO or CFO (In case of an Indian compa ny) or an authoris ed repres entative (In case of a foreign company) DSC Box Designation I I DIN of the direc tor; PAN of the manag er or CEO or CFO or Authorised representative; or membersh ip numb er of company secretary I.__ __,J

Declaration I/we confirm that the attached charge instrument(s) or document(s) is/are true copies of the original which is/are available with the charge holder and/or assignee and all the informa tion and particula rs mentio ned above are derived there from are concisely and correctly stated. I/we am/are duly authorised to sign this form. I/we am/are a multilateral/International financial institution who has/have been exempted from payment of income tax in India under the UN Privileges and Immunities Act.

To be digitally signed by esc Box Trustee of debenture holders or Charge Holder

PAN I I To be digitally signed by

esc Box ARC or assignee

MN I I ~------------------~

To be digitally signed by esc Box

Designation I I ~------------------~ PAN I I ~------------------~

Certifi cate by Practising professional I decla re that I have been duly engaged for the purpose of certification of this form. It is hereby certified tha t I have gone through the provisions of the Companies Act, 2013 and rules thereund er for the sub ject matter of this form and matters incidental thereto and I have verified the above particulars (including a ttachmen t(s )) from the original/certified records maintained by the Company/applicant which is subject matter of this form and found them to be true, correct and compl ete and no information ma te rial to this form has been suppressed. I further certify tha t:

i. The said reco rds have been proper ly prepa red, signed by the required officers of the Compan y and maintained as per the relevant provisions of the Companies Act, 2013 and were found to be in order;

Iii. All the required attachments have been completely and legibly attached to this form.

o Char te red accounta nt (in whole- t ime practice); or I 0 Cost acco untant (in whole-time practice); or DSC BOX

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, .•. •

o Company secreta r y (in whole- time practice)

Whether associate or fellow 0 Associate 0 Fellow Membe rship number I I Cer ti fica te of Practice number I I

~--------------~ Note: Attention is also drawn to provi sions of Section 447, section 448 and 449 of the Companies Act , 2013 which provide for punishment for fraud, puni shment for false statement and punishment for false evidence respectively

.. ' Prescrutiny

1.---------,1 (DD/MMf Y Y) L._ - -- '

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Check Form

For office use only:

eForm Ser ice request number (SRN) '-- -'1 eForm filing date

Digital signature of the authorising officer

This e-Form is hereby registered

Date of signing l 1 (DDIMMIYYYY)

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•• •

[F.No. 01/10/2013, Part-I CL-V]

L, K.V.R.Murty, Joint Secretary.

Note: The principal rules were published in the Gazette of India, Part II,

Section 3, Sub-section (i), vide number G.S.R. 248(E), dated the 31 st March,

2014 and subsequently amended vide the following notifications:-

Serial Notification Number Notification Date

Number

1. G.S.R 440(E) 29th May, 2015

2. G.S.R. 339 (E) 7th April, 2017

3. G.S.R. 614 (E) 5th Jul y, 2018

4. G.S.R.1218 (E) - 18th December, 2018

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