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FORM NO. CAA.10
[Pursuant to section 233(1)(c) and rule 25(2)]
Declaration of solvency
1. (a) Corporate identity number (CIN) of company :
(b) Global location number (GLN) of company:
2. (a) Name of the company:
(b) Address of the registered office of the company:
(c) E-mail ID of the company:
3.(a) Whether the company is listed:
? Yes
? No
(b) If listed, please specify the name(s) of the stock exchange(s) where listed:
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4. Date of Board of Directors’ resolution approving the scheme
Declaration of solvency
We, the directors of M/s …………………. do solemnly affirm and declare that we have made a full enquiry into the affairs of the company and have formed the opinion that the company is capable of meeting its liabilities as and when they fall due and that the company will not be rendered insolvent within a period of one year from the date of making this declaration.
We append an audited statement of company’s assets and liabilities as at ………… being the latest date of making this declaration.
We further declare that the company’s audited annual accounts including the Balance Sheet have been filed upto date with the Registrar of Companies …………………..
Signed for and behalf of the board of directors
(1) Signature :……………
Date Name :…………..
Place Managing Director, if any
(2) Signature :……………
Name :……………
Director
(3) Signature :…………….
Name :…………….
Director
Verification
We solemnly declare that we have made a full enquiry into the affairs of the company including the assets and liabilities of this company and that having done so and having noted that the scheme of merger or amalgamation between ………………… and …………………………..is proposed to be placed before the shareholders and creditors of the company for approval as per the provisions of sub-section of (1) of section 233 of the Companies Act, 2013, we make this solemn declaration believing the same to be true.
Verified this day the ……… day of …………….., 20……
(1) Signature :……………
Name :…………..
Managing Director
(2) Signature :……………
Name :……………
Director
(3) Signature :…………….
Name :…………….
Director
Solemnly affirmed and declared at ………… the ………………. day of ……………, 20… before me.
Commissioner of Oaths and
Notary Public
Attachments:
a) Copy of board resolution
b) Statement of assets and liabilities
c) Auditor’s report on the statement of assets and liabilities
ANNEXURE
Statement of assets and liabilities as at ……….
Name of the company …………………….
Assets
Book Estimated
Value Realisable value
1. Balance at Bank
2. Cash in hand
3. Marketable securities
4. Bills receivables
5. Trade debtors
6. Loans & advances
7. Unpaid calls
8. Stock-in-trade
9. Work in progress
10. Freehold property
11. Leasehold property
12. Plant and machinery
13. Furniture, fittings, utensils, etc.
14. Patents, trademarks, etc.
15. Investments other than
marketable securities
16. Other property
…………………… ……………………
Total:
…………………. ……………………
Liabilities
Estimated to rank for payment
(to the nearest rupee)
1. Secured on specific assets
2. Secured by floating charge(s)
3. Estimated cost of liquidation
and other expense including
interest accruing until payment
of debts in full.
4. Unsecured creditors
(amounts estimated
to rank for payment)
(a) Trade accounts
(b) Bills payable
(c) Accrued expense
(d) Other liabilities
(e) Contingent liabilities
………………………..
Total:
………………………..
Total estimated value of assets Rs. ………………………
Total liabilities Rs. ………………………
Estimated surplus after paying Rs. ………………………
debts in full
Remarks (1) Signature :……………
Name :…………..
Managing Director
(2) Signature :……………
Name :……………
Director
(3) Signature :…………….
Name :…………….
Director
Place : ……………
Date: ………….
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