Form No. 37 [See rule 126] [Heading as in form no 16] LLP Petition No of 20.. Statement of affairs under rule 28
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1 Form No 37 [See rule 126] [Heading as in form no 16] LLP Petition No of 20 Statement of affairs under rule 28 Statement of affairs of the above named LLP as on the day of 20, the date of petition or the winding up order or the order appointing Provisional Liquidator, as the case may be I/We of do solemnly affirm say that the statement made overleaf the several lists hereunto annexed marked `A to `G are to the best of my/our knowledge belief a full, true complete statement as to the affairs of the above LLP, on the day of 20, the date of the petition or winding-up order or the order appointing Provisional Liquidator that the said LLP carried/carried on the following business : (Here set out nature of LLP business) (s) Solemnly affirmed at This day of 20 Before me Commissioner of Oaths or Notary public STATEMENT OF AFFAIRS AND LISTS TO BE ANNEXED Statement as to the affairs of LLP (LLPIN ), on the day of 20, being the date of the petition or winding up order or order appointing Provisional Liquidator as the case may be showing assets at estimated realizable value liabilities:- (A)Assets I Assets specifically mortgaged/pledged or having fixed charge (excluding floating charge) (as per list `A ) Book Estimated value realizable values Due to secured workmen Deficiency ranking as unsecured Estimated Surplus
2 Freehold Property Leasehold Property Plant & Machinery Furniture, fittings etc Inventories Other assets Rs Rs Rs Rs Rs Rs II Assets not specifically mortgaged/pledged etc (as per List `B ) Balance at Bank Cash in h Investments Debtors/Trade receivables Loans & Advances Inventories Freehold Property Leasehold Property Plant & Machinery Furniture, fittings etc Intangible Assets Other Assets (to specify) Outsting contribution of the partners Book Value (Rs) Estimated realisable values (Rs) Gross Assets Gross realizable value of assets specifically mortgaged/pledged/having fixed charge Other assets Gross Assets Rs B Liabilities Gross Liabilities Secured including workmen dues Preferential Creditors having floating charge Unsecured creditor contingent liabilities Gross liabilities
3 Rs Estimated surplus from assets specifically mortgaged/ pledged/having fixed charge Assets which are not specifically Mortgaged/pledged etc Estimated total assets available for preferential, having floating charge unsecured Preferential (as per List C ) Estimated balance of assets available for having floating charge unsecured Creditors having floating charge (as per list D ) Estimated balance of assets available for unsecured unsecured balance of partly secured on specific assets Unsecured Creditors etc (as per List E ) Estimated balance available to partners Claim of partners (as per List F ) Note:- Positive balance is treated as Surplus negative balance is treated as Deficiency
4 LIST A TO THE STATEMENT OF AFFAIRS: Schedule I ASSETS SPECIFICALLY MORTGAGED, PLEDGED OR HAVING FIXED CHARGE (EXCLUDING FLOATING CHARGE) AND CREDITORS INCLUDING WORKMEN, FULLY OR PARTLY SECURED Particulars of assets specifically mortgaged/ pledged etc, Date when security given Estimated value of security Name of Amount of debt of secured Workmen dues Proportion of amount of secured Proportion of amount of workmen dues Balance of debt / workmen dues unsecured carried to List D Estimated surplus from security Assets Free hold property Leasehold property Plant machinery Furniture fittings Inventories etc Schedule II Description of Assets Specifically mortgaged /pledged etc Location Area Amount & description Holder of the title & the person who is having the custody of the title deeds
5 LIST B TO THE STATEMENT OF AFFAIRS Schedule I ASSETS NOT SPECIFICALLY MORTGAGED/PLEDGED ETC II Assets not specifically mortgaged/pledged etc Book Value Estimated realisable values Balance at Bank Cash in h Investments Debtors/Trade receivables Loans & Advances Inventories Freehold Property Leasehold Property Plant & Machinery Furniture, fittings etc Intangible Assets Other Assets (to specify) Outsting contribution of the partners (Rs) (Rs) Schedule II Name of the bank Bank balance Rs BALANCE AT BANK Nature of the Account No account / FD No (FD/SB/CA) Person in whose custody the FD is lying Name of the officer of the LLP who operated the account
6 Amount Schedule III CASH IN HAND Person in whose custody the cash is lying Person who was hling the cash in the LLP Nature of the investment Schedule IV INVESTMENTS Name of the body Date of corporate/institutions investment where invested Amount of investment Person in whose custody scrip(s) is/are lying Name whether related to designated partner Schedule V DEBTORS/TRADE RECEIVABLES (INCLUDING BILLS OF EXCHANGE PROMISSORY NOTES ETC) Amount Good or bad Within limitation or barred limitation When contacted supporting documents Legal proceeding instituted(full details) Particulars of any securities held Cr Bal Name whether related to Amount Good or bad Schedule VI LOANS & ADVANCES Within limitation or barred limitation When contacted supporting documents Legal proceeding instituted(full details) Particulars of any securities held
7 designated partner Schedule VII INVENTORIES Description Amount Quantity Location Since when lying Assets Free hold property Leasehold property Plant machinery Furniture fittings etc Schedule VIII DESCRIPTION OF OTHER ASSETS Area Location & description Holder of the title & person in whose custody the title deeds are lying Amount Schedule IX OUTSTANDING CONTRIBUTION OF THE PARTNERS Name Amount Nature of the Since when Any obligation of the outsting contribution outsting partner LIST C TO THE STATEMENT OF AFFAIRS PREFERENTIAL CREDITORS
8 No Name of creditor Address & occupation Nature of claim Period during which claim accrued due Date when due Amount of claim Amount payable in full Balance not preferential carried to List D LIST D TO THE STATEMENT OF AFFAIRS CREDITORS HAVING FLOATING CHARGE No Name of Holder Address Amount Rs Description of assets over which security extends
9 LIST E TO THE STATEMENT OF AFFAIRS UNSECURED CREDITORS ETC, No Name Address Amount Date when contacted Unsecured Document in support consideration Unsecured balance of partly secured brought from List A Balance not preferential brought from List D Name & LIST F TO THE STATEMENT OF AFFAIRS Amount of contribution LIST OF PARTNERS Nature of contribution Since when the partner & whether designated partner Amount of outsting contribution
10 LIST G TO STATEMENT OF AFFAIRS DEBT DUE FROM PARTNERS No Name Residential Amount of Debts Details of When Particulars documents in support contracted whether good or bad of any security held for debt Note:- Contra entry shall be disclosed with full details Dated 20
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