(See sub-rule (1) of rule 4)
APPLICATION BY FINANCIAL CREDITOR(S) TO INITIATE CORPORATE INSOLVENCY RESOLUTION PROCESS UNDER THE CODE.
(Under section 7 of the Insolvency and Bankruptcy Code, 2016 read with Rule 4 of the Insolvency and Bankruptcy
(Application to Adjudicating Authority) Rules, 2016)
The National Company Law Tribunal
In the matter of
Subject: Application to initiate corporate insolvency resolution process in the matter of [ name of the corporate debtor ] under the Insolvency and Bankruptcy Code, 2016.
[ Names of the financial creditor(s) ], hereby submit this application to initiate a corporate insolvency resolution process in the matter of [ name of the corporate debtor ]. The details for the purpose of this application are set out below:
PARTICULARS OF APPLICANT (PLEASE PROVIDE FOR EACH FINANCIAL CREDITOR MAKING THE APPLICATION)
Name of financial creditor
[ Name of financial creditor ]
Date of incorporation of financial creditor
Identification number of financial creditor
Address of the registered office of the financial creditor
[ Address of the registered office of the financial creditor ]
Name and address of the person authorised to submit application on its behalf (enclose authorisation)
Name and address of person resident in India authorised to accept the service of process on its behalf
PARTICULARS OF THE CORPORATE DEBTOR
Name of the corporate debtor
[ name of corporate debtor ]
Identification number of corporate debtor
Date of incorporation of corporate debtor
Nominal share capital and the paid-up share capital of the corporate debtor and/or details of guarantee
clause as per Memorandum of Associations (As Applicable)
Address of the registered office of the corporate debtor
PARTICULARS OF THE PROPOSED INTERIM RESOLUTION PROFESSIONAL
Name, address, email address and the registration number of the proposed interim resolution professional
PARTICULARS OF FINANCIAL DEBT
Total amount of debt granted date(s)
Amount claimed to be in default and the date on which the default occurred (attach the workings for
computation of amount and days of default in tabular form)
PARTICULARS OF FINANCIAL DEBT [DOCUMENTS, RECORDS AND EVIDENCE OF DEFAULT]
Particulars of security held, if any, the date of its creation, its estimated value as per the creditor.
Attach a copy of a certificate of registration of charge issued by the Registrar of Companies (if the corporate debtor is a company)
Particulars of an order of a court, tribunal or arbitral panel adjudicating on the default, if any (Attach a copy of the Order)
Record of default with theinformation utility, if any
(Attach a copy of such Record)
Details of succession certificate, or probate of a will, or letter of administration, or court decree (as may be applicable), under the Indian Succession Act, 1925 (10 of 1925)
(Attach a Copy)
The latest and complete copy of the financial contract reflecting all amendments and waivers to date
A record of default as available with any credit Information Company
(Attach a Aopy)
Copies of entries in a bankers book in accordance with the Bankers Books Evidence Act, 1891 (18 of 1891)
List of other documents attached to this application in order to prove the existence of financial debt, the amount and date of default
I, hereby certify that, to the best of my knowledge, [ name of proposed insolvency professional ], is fully qualified and permitted to act as an insolvency professional in accordance with the Insolvency and Bankruptcy Code, 2016 and the associated rules and regulations.
[ Name of the financial creditor ] has paid the requisite fee for this application through
Signature of person authorised to act on behalf of the financial creditor
Name in block letters
Position with or in relation to the financial creditor
Address of person signing
Please attach the following to this application:
Copies of all documents referred to in this application.
Written communication by the proposed interim resolution professional as set out in Form 2.
Proof that the specified application fee has been paid.
Where the application is made jointly, the particulars specified in this form shall be furnished in respect of all the joint applicants along with a copy of authorisation to the financial creditor to file and act on this application on behalf of all the applicants.
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