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APPLICATION BY GUARANTOR TO INITIATE INSOLVENCY RESOLUTION PROCESS-Application to Adjudicating Authority for Insolvency Resolution Process

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..... Title and full name 2. Date of birth and e-mail address 3. Any other name, if any, by which the guarantor is or has been known 4. Address: (i) Present (ii) Permanent (iii) Business 5. Occupation/ Business/ Profession 6. Annual income in the preceding financial year (in Rs.) 7. List of associates of the guarantor, including relatives, who are its creditors Name Age Address 8. Bank accoun .....

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..... Investment in other funds Investment in partnerships and other business concerns Any other movable property 12. Number of directorships held in the last three preceding years (along with name of company in which directorship is held) and CIN of such companies 13. Marital status (single, married, divorced, widowed, cohabiting, separated, or specify if any other) 14. Details regarding guarantee(s) given by guarantor (in addition to information in serial numbers 1-13 of this part)- Name of corporate debtor for which guarantee is given .....

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..... PARTICULARS OF DEBT [CREDITOR WISE, AS APPLICABLE] 1. Name(s) of creditor(s) 2. Address Present Permanent Business 3. Total debt (including any interest or penalties) 4. Amount of debt in default 5. Interest or penalties, if any 6. Date when the debt was due 7. Date when the default occurred 8. Nature of the debt 9. .....

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..... Contact number Home Mobile Business 5. Declaration by resolution professional I, [ name of insolvency professional ], an insolvency professional enrolled with [ name of insolvency professional agency ] having registration number [ registration number ] have been proposed as the resolution professional by [ name of applicant guarantor ] in connection with the proposed insolvency resolution process of [ name of the guarantor ]. I hereby: (i) agree to accept appointment as the resolution professional if an order of appointment is passed by the Adjudicating Authority; (ii) state that the registration number allotted to me by the Board is [ insert registration number ] and that I am currently qualified to practice as an insolvency professional; (iii) disclose that I am currently serving as an insolvency professional / resolution professional / liquidator/ bankrup .....

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..... f the Applicant) ATTACHMENTS: List of documents to be appended to the application: 1. All documents mentioned in serial number 14 of Part III of this form. 2. Copy of the income tax returns with detailed computation of the income of the guarantor, or the firm, as the case may be, for the previous three years. 3. Copy of the personal guarantee contract. 4. Copies of entries in a bankers book in accordance with the Bankers Books Evidence Act, 1891 (18 of 1891) 5. The latest and complete copy of the financial contract reflecting all amendments and waivers to date. 6. Copies of relevant ownership and title documents for all assets. 7. Copy of the authorisation, wherever required under this form. 8. Proof that the application fee has been paid. 9. Documentary evidence of all information sought in each entry for each Part of the form. 10. A statement of affairs of the guarantor made up to a date not earlier than seven days from the date of the application including the following information and supporting documents, namely:- .....

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