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 and say that the statement made overleaf and the several lists hereunto annexed marked `A’ to `G’ are to the best of my/our knowledge and belief a full, true and 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 and that the said LLP carried/carried on the following business : (Here set out nature of LLP business) …………… Signature(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 and liabilities:- (A)Assets I. Assets specifically mortgaged/pledged Book Estimated value realizable values Due to secured creditors Deficiency ranking as unsecured Estimated Surplus or having fixed charge (excluding floating charge) (as per list `A’) and workmen
Assets Location address & description Area Holder of the title & the person who is having the custody of the title deeds Amount Free hold property Leasehold property Plant and machinery Furniture and fittings Inventories etc. Particulars of assets specifically mortgaged/ pledged etc, Date when security given Estimated value of security Name and address of creditors Amount of debt of secured creditors Workmen dues 1. 2. 3. 4. 5. 6. Proportion of amount of secured creditors Proportion of amount of workmen dues Balance of debt / workmen dues unsecured carried to List ‘D’ Estimated surplus from security 7. 8. 9. 10. 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 Signature Dated…………20………. Schedule II Signature Dated…………20……….
II. Assets not specifically mortgaged/pledged etc. Book Value (Rs.) Estimated realisable values (Rs.) Balance at Bank Cash in hand Investments Debtors/Trade receivables Loans & Advances Inventories Freehold Property Leasehold Property Plant & Machinery Furniture, fittings etc. Intangible Assets Other Assets (to specify) Outstanding contribution of the partners Name and address of the bank Bank balance Rs. Nature of the account (FD/SB/CA) Account No. / F.D No. Person in whose custody the F.D. is lying Name and address of the officer of the LLP who operated the account . LIST ‘B’ TO THE STATEMENT OF AFFAIRS Schedule I ASSETS NOT SPECIFICALLY MORTGAGED/PLEDGED ETC. Signature Dated…………20………. Schedule II Signature Dated…………20……….
Name and address and whether related to designated partner Amount Good or bad Within limitation or barred limitation When contacted and supporting documents Legal proceeding instituted(full details) Particulars of any securities held Cr. Bal. . Nature of the investment Name of the body corporate/institutions where invested Date of investment Amount of investment Person in whose custody scrip(s) is/are lying . Amount Person in whose custody the cash is lying Person who was handling the cash in the LLP Schedule III CASH IN HAND Signature Dated…………20………. Schedule IV Signature Dated…………20………. Schedule V DEBTORS/TRADE RECEIVABLES Signature Dated…………20………. Schedule VI LOANS & ADVANCES Name and address and whether Amount Good or bad Within limitation or barred limitation When contacted and supporting Legal proceeding instituted(full details) Particulars of any securities held related to documents
Assets Location address & description Area Holder of the title & person in whose custody the title deeds are lying Amount Free hold property Leasehold property Plant and machinery Furniture and fittings etc. Name and address of the partner Amount outstanding Nature of the contribution Since when outstanding Any obligation designated partner . Description Amount Quantity Location address Since when lying . Signature Dated…………20………. Schedule VII Signature Dated…………20………. Schedule VIII Signature Dated…………20………. Schedule IX Signature Dated…………20………. LIST ‘C’ TO THE STATEMENT OF AFFAIRS PREFERENTIAL CREDITORS
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’ . No. Name of Holder Address Amount Rs. Description of assets over which security extends . Signature Dated…………20………. LIST ‘D’TO THE STATEMENT OF AFFAIRS Signature Dated…………20……….
No. Name Address Amount Date when contacted Document in support consideration Unsecured creditors ------- ------- ------- ------- Unsecured balance of creditors partly secured brought from List ‘A’ Balance not preferential creditors brought from List ‘D’ _______ _______ _______ _______ _______ _______ _______ Name & address Amount of contribution Nature of contribution Since when the partner & whether designated partner Amount of outstanding contribution LIST ‘E’ TO THE STATEMENT OF AFFAIRS Signature Dated…………20………. LIST ‘F’ TO THE STATEMENT OF AFFAIRS Signature Dated…………20……….