[See rule 296]

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..... t. Number on list of creditors Name of the creditor to whom the distributable sum is due Last known address of creditor Date of declaration and rate of distributable sum Total amount of distributable sum payable Last date when payable Amount paid into LLPs Liquidation account Remarks Date Rate 1 .....

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..... Total................ Total amount of unclaimed distributable sums paid into the LLPs Liquidation Account Rs. ..... Total amount of undistributed assets paid into the LLPs Liquidation Account Rs. ..... Total amount paid under both heads ............... Dated this.....day of.....20..... (Sd.) Liquidator or LLP Liquidator - - statut .....

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