Comply Crafter

Sr. No

Optional attachment(s) - if any

1.

Sr. No

Attachments

1.

2.

I am authorized by the Board of Directors of the Company vide resolution no Dated to sign this form and declare that all the requirements of Companies Act, 2013 and the rules made thereunder in respect of the subject matter of this form and matters incidental thereto have been complied with. I also declare that all the information given herein above is true, correct and complete and as per the attached charge instrument(s) or document(s) and nothing material has been suppressed. A copy of the attached charge instrument(s) or document(s) is/ are available at the registered office or principal place of business in India of the company.

I further declare that:

The delay in filing the particulars of creation/modification, was accidental or due to inadvertence or some other sufficient cause and are or is not of a nature to prejudice the position of the charge holder, shareholders or creditors of the company;
No prejudice would be caused to the charge holder(s) or any other creditor(s) of the company, if the delay is condoned;
The company has not created or modified any other charge(s) whatsoever on the assets of the company, since the creation / modification of the present charge;
The company is carrying on the business as on the date of filing this application and no proceedings to wind-up the company have commenced or are pending against the company;
There is no litigation proceedings pending before any court of law for which condonation of delay is being filed;
The company has not applied for striking off the name of the company from the register of Registrar of Companies

Designation

DIN of the director; PAN of the manager or CEO or CFO or IRP/RP/Liquidator or Authorised representative ; or membership number of company secretary

Declaration & DSC_Charge Holder / ARC / Assignee

I/we confirm that the attached charge instrument(s) or document(s) is/are true copies of the original which is/are available with the charge holder and/or assignee and all the information and particulars mentioned above are derived there from are concisely and correctly stated. I/we am/are duly authorised to sign this form

I/we am/are a multilateral/International financial institution who has/have been exempted from payment of income tax in India under the UN Privileges and Immunities Act.

Pan of Charge Holder

Email ID of Charge Holder

PAN of ARC/Assignee

E-mail ID of the company

To be digitally signed by

Designation

PAN

Email ID

(b) If Modification then Charge ID

Certificate by CA or CS or CoA

Chartered accountant (in whole-time practice) Cost accountant (in whole-time practice) Company secretary (in whole-time practice)

Whether associate or fellow :

Associate Fellow

Membership number

Details of charge instrument and Type

Corporate Identity Number (CIN) or Foreign Company Registration Number (FCRN)

Name of the Company

Address of the registered office or principal place of business in India of the company

E-mail ID of the company

Date of satisfaction of charge in full

Charge creation identification (ID) number

Whether the form is being filed

(i) Beyond 30 days but within 300 days from the date of satisfaction Yes No

If yes, give reasons for the delay and mention the duration of delay

(ii) Beyond 300 days (if yes, an application will be required to be made to Central Government for extension of further time) Yes No

Whether the applicant is Company Chargeholder

Whether the charge is satisfied in favour of asset reconstruction company or assignee Yes No

Particulars of the charge holder or ARC or assignee

Name of the charge holder

In case of others, CIN (if applicable)

Name

Email

Address

Particulars of creation of original charge and subsequent modifications

Charge creation date

Charge last modified date (if applicable)

Final amount secured (in INR)

Amount secured by the charge in words

In case amount secured by the charge is in foreign currency, mention details

Form No.CHG-4

Sr. No

Optional attachment(s) - if any

Details of charge instrument and Type

Whether the form is being filed

Particulars of the charge holder or ARC or assignee

Particulars of creation of original charge and subsequent modifications