Statement

(Pursuant to Part B of the Form 18)

I, ________, shareholder of _______________ and also named in the incorporation document of ________________ LLP as a designated partner give my consent for the conversion of the said company _____________ into the Limited Liability Partnership.

I state as under:

(i) that all the requirements of the Limited Liability Partnership Act, 2008 and the rules made thereunder have been complied with, in respect of conversion of private company/ unlisted public company into limited liability partnership and matters precedent and incidental thereto;

(ii) that all the partners of the limited liability partnership comprise all the shareholders of the company and no one else;

(iii) that the applicable clearances, approvals or permissions for conversion of the company into a limited liability partnership from any authority/authorities have been obtained.

(iv) that the consent of all the unsecured creditors for conversion of the company into limited liability partnership has been obtained;

(v) that all the documents due for filing including balance sheet and annual return for the immediately preceding financial year have been filed under the provision of the Companies Act, 1956;

(vi) that to the best of my knowledge and belief, the information given in this form and its attachments is correct and complete.

<<Name of the Shareholder>>

Place: 

Date: