FormNo.37
[Seerule126]
[Headingasinformno16]
LLPPetitionNo………of20……..
Statementofaffairsunderrule28
StatementofaffairsoftheabovenamedLLPasonthe……dayof……20….,thedateof
petitionorthewindinguporderortheorderappointingProvisionalLiquidator,asthe
casemaybe.
I/We……..of…….dosolemnlyaffirmandsaythatthestatementmadeoverleafandthe
severallistshereuntoannexedmarked`A’to`G’aretothebestofmy/ourknowledgeand
beliefafull,trueandcompletestatementastotheaffairsoftheaboveLLP,onthe……
dayof……20…..,thedateofthepetitionorwinding-uporderortheorderappointing
ProvisionalLiquidatorandthatthesaidLLPcarried/carriedonthefollowingbusiness:
(HeresetoutnatureofLLPbusiness)
……………
Signature(s)
Solemnlyaffirmedat…….This……..dayof……..20….Beforeme.
CommissionerofOathsorNotarypublic
STATEMENTOFAFFAIRSANDLISTSTOBEANNEXED
Statementastotheaffairsof………….LLP(LLPIN______),onthe……..dayof…..20,
beingthedateofthepetitionor windinguporderororderappointingProvisional
Liquidatorasthecasemaybeshowingassetsatestimatedrealizablevalueand
liabilities:-
(A)Assets
I.Assets
specifically
mortgaged/pledged
BookEstimated
valuerealizable
values
Dueto
secured
creditors
Deficiency
rankingas
unsecured
Estimated
Surplus
orhavingfixed
charge(excluding
floatingcharge)
(asperlist`A’)
and
workmen
II.Assetsnotspecificallymortgaged/pledgedetc.(asperList`B’) / BookValue
(Rs.) / Estimated
realisablevalues
(Rs.)
BalanceatBank
Cashinhand
Investments
Debtors/Tradereceivables
LoansAdvances
Inventories
FreeholdProperty
LeaseholdProperty
PlantMachinery
Furniture,fittingsetc.
IntangibleAssets
OtherAssets(tospecify)
Outstandingcontributionofthepartners
FreeholdProperty
LeaseholdProperty
PlantMachinery
Furniture,fittings
etc
Inventories
Otherassets
…………………
………………… / Rs. / Rs. / Rs. / Rs. / Rs.
Rs.
GrossAssets
Rs.
Grossrealizablevalueofassetsspecifically
mortgaged/pledged/havingfixedcharge ______
Otherassets ______
GrossAssets ______
B.Liabilities
GrossLiabilities ______
Securedcreditorsincludingworkmendues. ______
Preferentialcreditors ______
Creditorshavingfloatingcharge ______
Unsecuredcreditor
andcontingentliabilities ______
Grossliabilities ______
Estimatedsurplusfromassetsspecificallymortgaged/
pledged/havingfixedcharge
AssetswhicharenotspecificallyMortgaged/pledgedetc.
Estimatedtotalassetsavailableforpreferentialcreditors,
creditorshavingfloatingchargeandunsecuredcreditors
Preferentialcreditors(asperList‘C’)
Estimatedbalanceofassetsavailableforcreditorshaving
floatingchargeandunsecuredcreditors
Creditorshavingfloatingcharge(asperlist‘D’)
Estimatedbalanceofassetsavailableforunsecuredcreditors
andunsecuredbalanceofcreditorspartlysecuredonspecific
assets.
UnsecuredCreditorsetc.(asperList‘E’)
Estimatedbalanceavailabletopartners
Claimofpartners(asperList’F’)
Rs.
______
______
______
______
______
______
______
______
______
______
Note:-Positivebalanceistreatedas‘Surplus’andnegativebalanceistreatedas
‘Deficiency’
Signature
Dated…………20……….
Assets / Locationaddress
description / Area / Holderofthe
titlethe
personwhois
havingthe
custodyofthe
titledeeds / Amount
Freehold
property
Leasehold
property
Plantand
machinery
Furnitureand
fittings
Inventoriesetc.
Particularsof
assets
specifically
mortgaged/
pledgedetc, / Datewhen
security
given / Estimated
valueof
security / Name
and
address
of
creditors / Amount
ofdebt
of
secured
creditors / Workmendues
1. / 2. / 3. / 4. / 5. / 6.
Proportionof
amountof
secured
creditors / Proportionof
amountof
workmendues / Balanceofdebt
/workmendues
unsecured
carriedtoList
‘D’ / Estimated
surplusfrom
security
7. / 8. / 9. / 10.
LIST“A”TOTHESTATEMENTOFAFFAIRS:
ScheduleI
ASSETSSPECIFICALLYMORTGAGED,PLEDGEDORHAVINGFIXEDCHARGE
(EXCLUDINGFLOATINGCHARGE)ANDCREDITORSINCLUDINGWORKMEN,
FULLYORPARTLYSECURED
Signature Dated…………20……….
ScheduleII
Signature Dated…………20……….
II.Assetsnotspecificallymortgaged/pledgedetc. / BookValue
(Rs.) / Estimated
realisablevalues
(Rs.)
BalanceatBank
Cashinhand
Investments
Debtors/Tradereceivables
LoansAdvances
Inventories
FreeholdProperty
LeaseholdProperty
PlantMachinery
Furniture,fittingsetc.
IntangibleAssets
OtherAssets(tospecify)
Outstandingcontributionofthepartners
Nameand
addressof
thebank / Bank
balance
Rs. / Natureofthe
account
(FD/SB/CA) / AccountNo.
/F.DNo. / Personin
whose
custodythe
F.D.islying / Nameand
addressof
theofficer
ofthe
LLPwho
operated
the
account
.
LIST‘B’TOTHESTATEMENTOFAFFAIRS
ScheduleI
ASSETSNOTSPECIFICALLYMORTGAGED/PLEDGEDETC.
Signature Dated…………20……….
ScheduleII
Signature Dated…………20……….
Nameandaddress
and
whether
relatedto
designated
partner / Amount / Good
or
bad / Within
limitation
orbarred
limitation / When
contacted
and
supporting
documents / Legal
proceeding
instituted(full
details) / Particulars
ofany
securities
held / Cr.
Bal.
.
Natureofthe
investment / Nameofthebody
corporate/institutions
whereinvested / Dateof
investment / Amountof
investment / Personin
whose
custody
scrip(s)is/are
lying
.
Amount / Personin
whosecustody
thecashislying / Personwho
washandling
thecashinthe
LLP
ScheduleIII
CASHINHAND
Signature Dated…………20……….
ScheduleIV
Signature Dated…………20……….
ScheduleV
DEBTORS/TRADERECEIVABLES
Signature Dated…………20……….
ScheduleVI
LOANSADVANCES
Nameand
address
and
whether
AmountGoodor
bad
Within
limitation
orbarred
limitation
When
contacted
and
supporting
Legal
proceeding
instituted(full
details)
Particulars
ofany
securities
held
relatedto
documents
address
description / Area / Holderofthe
titleperson
inwhose
custodythetitle
deedsarelying / Amount
Freehold
property
Leasehold
property
Plantand
machinery
Furnitureand
fittingsetc.
Nameand
addressofthe
partner / Amount
outstanding / Natureofthe
contribution / Sincewhen
outstanding / Anyobligation
designated
partner
.
Description / Amount / Quantity / Location
address / Sincewhen
lying
.
Signature Dated…………20……….
Schedule VII
Signature Dated…………20……….
Schedule VIII
Signature Dated…………20……….
ScheduleIX
Signature Dated…………20……….
LIST‘C’TOTHESTATEMENTOFAFFAIRS
PREFERENTIALCREDITORS
No. / Nameof
creditor / Address
occupation / Nature
of
claim / Period
during
which
claim
accrued
due / Date
when
due / Amount
of
claim / Amount
payable
infull / Balance
not
preferential
carriedto
List’D’
.
No. / NameofHolder / Address / Amount
Rs. / Descriptionof
assetsover
whichsecurity
extends
.
Signature Dated…………20……….
LIST‘D’TOTHESTATEMENTOFAFFAIRS
Signature Dated…………20……….
No. / Name / Address / Amount / Datewhen
contacted / Document
insupport / consideration
Unsecured
creditors
------
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Unsecured
balanceof
creditorspartly
securedbrought
fromList‘A’
Balancenot
preferential
creditors
broughtfrom
List‘D’ / ______
______
______
______
______
______
______
Name
address / Amountof
contribution / Natureof
contribution / Sincewhenthe
partner
whether
designated
partner / Amountof
outstanding
contribution
LIST‘E’TOTHESTATEMENTOFAFFAIRS
Signature Dated…………20……….
LIST‘F’TOTHESTATEMENTOFAFFAIRS
Signature Dated…………20……….
LIST‘G’TOSTATEMENTOFAFFAIRS
DEBTDUEFROMPARTNERS
No.NameResidentialAmountofDebts Detailsof
When
Particulars
address
documentsin
support
contracted
andwhether
goodorbad
ofany
security
heldfor
debt
Note:-Contraentryshallbedisclosedwithfulldetails.
Signature
Dated…………20…