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PROOF OF CLAIM BY AUTHORISED REPRESENTATIVE OF WORKMEN OR EMPLOYEES- Regulation 19- Liquidation Process

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..... set out in the public announcement] From [Name and address of the authorised representative of workmen/ employees] Subject: Submission of proof of claim in respect of the liquidation of [name of corporate debtor] under the Insolvency and Bankruptcy Code, 2016. Madam/Sir, I, [name of duly authorised representative of the workmen/ employees] currently residing at [address of duly authorised rep .....

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..... 2. That for which said sums or any part thereof, they have not, nor has any of them, had or received any manner of satisfaction or security whatsoever, save and except the following: [Please state details of any mutual credits, mutual debts, or other mutual dealings between the corporate debtor and the workmen / employees which may be set-off against the claim.] Signature : ANNEXURE 1. Details .....

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..... [insert full name, address and occupation of deponent] do solemnly affirm and state as follows: 1. The above named corporate debtor was, at the liquidation commencement date that is, the . . . . . . . . . . . day of . . . . . . . . . . . 20. . . . . and still is, justly and truly indebted to the workmen and employees in the sum of Rs. . . . . . . . . . . . for . . . . . . . . . . . [please state .....

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..... . on . . . . . . . . . . . day, the . . . . . . . . . . . day of 20. . . . . . . . Before me, Notary / Oath Commissioner. Deponent's signature VERIFICATION I, the Deponent hereinabove, do hereby verify and affirm that the contents of para ___ to __of this affidavit are true and correct to my knowledge and belief. Nothing is false and nothing material has been concealed therefrom. Verifi .....

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