Form 1
(See sub-rule (1) of rule 4)
APPLICATION BY FINANCIAL CREDITOR(S) TO INITIATE CORPORATE INSOLVENCY RESOLUTION
PROCESS *UNDER CHAPTER II OF PART II/ UNDER CHAPTER IV OF PART II OF THE CODE
[*strike out whichever is not applicable] APPLICATION BY FINANCIAL CREDITOR(S) TO INITIATE
CORPORATE INSOLVENCY RESOLUTION PROCESS UNDER THE CODE.
(Under section 7 of the Insolvency and Bankruptcy Code, 2016 read with Rule 4 of the Insolvency
and Bankruptcy
(Application to Adjudicating Authority) Rules, 2016)
[Date]
To,
The National Company Law Tribunal
[Address]
From,
[Names and addresses of the registered offices of the financial creditors]
In the matter of [name of the corporate debtor]
Subject: Application to initiate corporate insolvency resolution process in the matter of
[name of the corporate debtor] under the Insolvency and Bankruptcy Code, 2016.
Madam/Sir,
[Names of the financial creditor(s)], hereby submit this application to initiate a corporate
insolvency resolution process in the matter of [name of corporate debtor]. The details for the
purpose of this application are set out below:
Part-I
PARTICULARS OF APPLICANT (PLEASE PROVIDE FOR EACH FINANCIAL CREDITOR MAKING THE APPLICATION)
1. NAME OF FINANCIAL CREDITOR
2. DATE OF INCORPORATION OF FINANCIAL
CREDITOR
3. IDENTIFICATION NUMBER OF FINANCIAL
CREDITOR
4. ADDRESS OF THE REGISTERED OFFICE OF THE
FINANCIAL CREDITOR
5. NAME AND ADDRESS OF THE PERSON
AUTHORISED TO SUBMIT APPLICATION ON ITS
BEHALF
(ENCLOSE AUTHORISATION)
6. NAME AND ADDRESS OF PERSON RESIDENT IN
INDIA AUTHORISED TO ACCEPT THE SERVICE
OF PROCESS ON ITS BEHALF
(ENCLOSE AUTHORISATION)
Part II
PARTICULARS OF THE CORPORATE DEBTOR
1. NAME OF THE CORPORATE DEBTOR
2. IDENTIFICATION NUMBER OF CORPORATE
DEBTOR
3. DATE OF INCORPORATION OF CORPORATE
DEBTOR
4. NOMINAL SHARE CAPITAL AND THE PAID-UP
SHARE CAPITAL OF THE CORPORATE DEBTOR
AND/OR DETAILS OF GUARANTEE CLAUSE AS PER MEMORANDUM OF ASSOCIATION (AS
APPLICABLE)
5 ADDRESS OF THE REGISTERED OFFICE OF THE
CORPORATE DEBTOR
6. DETAILS OF THE CORPORATE DEBTOR AS PER THE
NOTIFICATION UNDER SECTION 55 (2) OF THE CODE –
(i) ASSETS AND INCOME
(ii) CLASS OF CREDITORS OR AMOUNT OF DEBT
(iii) CATEGORY OF CORPORATE PERSON
(WHERE APPLICATION IS UNDER CHAPTER IV OF PART
II OF THE CODE) (Inserted vide vide the Insolvency and Bankruptcy (Application to Adjudicating Authority) Amendmen
Part III
PARTICULARS OF THE PROPOSED INTERIM RESOLUTION PROFESSIONAL
1 NAME, ADDRESS, EMAIL ADDRESS AND THE
REGISTRATION NUMBER OF THE PROPOSED
INTERIM RESOLUTION PROFESSIONAL
Part IV
PARTICULARS OF FINANCIAL DEBT
1. TOTAL AMOUNT OF DEBT GRANTED
DATE(S) OF DISBURSEMENT
2. AMOUNT CLAIMED TO BE IN DEFAULT AND THE
DATE ON WHICH THE DEFAULT OCCURRED
(ATTACH THE WORKINGS FOR COMPUTATION OF
AMOUNT AND DAYS OF DEFAULT IN TABULAR
FORM)
Part V
PARTICULARS OF FINANCIAL DEBT [DOCUMENTS, RECORDS AND EVIDENCE OF DEFAULT
1. PARTICULARS OF SECURITY HELD, IF ANY, THE DATE OF ITS CREATION, ITS ESTIMATED VALU
CREDITOR.
ATTACH A COPY OF A CERTIFICATE OF REGISTRATION OF CHARGE ISSUED BY THE REGISTRAR OF CO
THE CORPORATE DEBTOR IS A COMPANY)
2. PARTICULARS OF AN ORDER OF A COURT, TRIBUNAL OR ARBITRAL PANEL ADJUDICATING O
ANY
(ATTACH A COPY OF THE ORDER)
3. RECORD OF DEFAULT WITH THE INFORMATION UTILITY, IF ANY
(ATTACH A COPY OF SUCH RECORD)
4. DETAILS OF SUCCESSION CERTIFICATE, OR PROBATE OF A WILL, OR LETTER OF ADMINISTRA
DECREE (AS MAY BE APPLICABLE), UNDER THE INDIAN SUCCESSION ACT, 1925 (10 OF 1925)
(ATTACH A COPY)
5. THE LATEST AND COMPLETE COPY OF THE FINANCIAL CONTRACT REFLECTING ALL AMEND
TO DATE
(ATTACH A COPY)
6. A RECORD OF DEFAULT AS AVAILABLE WITH ANY CREDIT INFORMATION COMPANY
(ATTACH A COPY)
7. COPIES OF ENTRIES IN A BANKERS BOOK IN ACCORDANCE WITH THE BANKERS BOOKS EVID
OF 1891)
(ATTACH A COPY)
8. LIST OF OTHER DOCUMENTS ATTACHED TO THIS APPLICATION IN ORDER TO PROVE THE EX
DEBT, THE AMOUNT AND DATE OF DEFAULT
I, hereby certify that, to the best of my knowledge, [name of proposed insolvency
professional], is fully qualified and permitted to act as an insolvency professional in accordance with
the Insolvency and Bankruptcy Code, 2016 and the associated rules and regulations.
-[Name of the financial creditor] has paid the requisite fee for this application through [state
means of payment] on [date] and served a copy of this application by registered post/speed post/by
hand/electronic means to the registered office of the corporate debtor and to the Board.
[Name of the financial creditor] has paid the requisite fee for this application through [state
means of payment] on [date].
Yours sincerely,
Signature of person authorised to act on behalf of the financial creditor
Name in block letters
Position with or in relation to the financial creditor
Address of person signing
Instructions
Please attach the following to this application:
Annex I – Copies of all documents referred to in this application.
Annex II- Written communication by the proposed interim resolution professional as set out
in Form 2.
Annex III -Proof that the specified application fee has been paid.
Annex IV -Where the application is made jointly, the particulars specified in this form shall
be furnished in respect of all the joint applicants along with a copy of authorisation to the financial
creditor to file and act on this application on behalf of all the applicants.
Annex V Proofs of serving a copy of the application (a) to the corporate debtor, and (b) to
the Board.
