Form No.
PAS-3 Form language
English Hindi
Return of Allotment
[Pursuant to section 39(4) and 42 (9) of the Companies Act,
2013 and rule 12 and 14 of the Companies (Prospectus and
Allotment of Securities) Rules,2014
AB2500335_SRN_FORM_1737615795770
Refer instruction kit for filing the form
All fields marked in * are mandatory. 1737615795770
1.Company Information
(a) *Corporate Identity Number (CIN) U72900KL2019PTC058458
(b) *Name of the company
PROPHAZE TECHNOLOGIES
PRIVATE LIMITED
(c) *Address of the Registered Office of the company
C/o RAJEEVAN D,THOPPIL, S V M
P.O,KOZHIKODU
WEST,,KARUNAGAPPALLY,KOLLAM,
Kollam,Kerala,690573,India
(d) *Email ID of the company
*****prophaze.com
2. *Number of allotments 1
3. *Type of security
(Equity/Preference/ Debentures) Equity
4.(a) If Equity: Type of allotment
Right issue
(Public issue/Bonus issue/Right issue/Conversion of Loans/ Conversion of debenture/ Conversion of preference
shares Private placement/ Preferential allotment/Employee stock option Plan (ESOP)/. Sweat equity/Others)
(b) If Others, please provide details
(c) If Preference: Type of allotment
(Public issue/Bonus issue/Right issue/Conversion of Loans/ Conversion of debenture/
Private placement/ Preferential allotment/Employeestock option Plan (ESOP)/Sweat equity/Others)
(d) If Others, please provide details
(e) If Debentures: Type of allotment
(Public issue/Conversion of Loans/Private placement/Preferential allotment/Others)
(f) If Others, please provide details
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(g) Whether Convertible or Non-convertible Convertible Non-convertible
5. Mode of allotment Cash Other than cash
6.*Date of allotment
05/12/2024
■ It is confirmed that no such return of allotment is pending to be filed for securities allotted prior to the date of allotment
mentioned in field 6.
Detail of resolution
7. Details of Shareholder’s Resolution passed
(a) Date of passing Shareholder’s Resolution
(b) SRN of MGT 14
8. Details of Board Resolution passed
(a) *Date of passing Board Resolution (DD/MM/YYYY) 05/12/2024
(b) *Mode of resolution Board Meeting Circulation
(c) *Number of votes cast in favor 2
(d) *Number of votes cast against
0
9 Particulars of Securities allotted for cash
(a) Class of security Equity
(b) Brief particulars of terms and conditions Pari passu with existing equity shares
(c) Number of securities allotted 448
Nominal Amount per Premium Amount per Discount Amount per security Total Amount (in INR) *
security (in INR) * security (in INR) (in INR)
10 13382 0
Particulars Amount Total Amount Amount Total Amount Amount due and Total Amount Amount due Total Amount
due and paid (in INR) due and paid (in INR) payable per paid (in INR) and payable paid (in INR)
payable payable security(in INR) per security
per per (in INR)
security (in security (in
INR) INR)
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On application* 10 4480.00 13382 5995136.00 0 0.00 13392 5999616
On allotment 0 0.00 0 0.00 0 0.00 0 0
On calls* 0 0.00 0 0.00 0 0.00 0 0
Total amount* 10 4480 13382 5995136 0 0 13392 5999616
10. Particulars of securities allotted for consideration other than cash
(a) *Class of security
(b) *Number of securities allotted
(c) *Nominal amount per security (in INR)
(d) Premium amount per security (in INR)
(e) Discount amount per security (in INR)
(f) *Amount to be treated as paid up on each security (in INR)
(g) *Total nominal amount (in INR)
(h) Total premium amount (if any) (in INR)
(i) Total discount amount (if any) (in INR)
11.*Details of Consideration
Consideration for which such securities have been allotted Description of the consideration Value (amount in INR)
Property and assets acquired
Goodwill
Services (give nature of services)
Other items (to be specified)
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12. *Whether an agreement or contract is executed in writing consideration other than cash Yes No
*Particulars of Agreement/Contract
(a) *Date of agreement (DD/MM/YYYY)
(b) *Parties to agreement
(c) *Brief particulars of agreement
13. *Whether valuation report of the Registered Valuer has been obtained for valuation Yes No
of assets issued in lieu of shares allotted for consideration other than cash
Key information on valuation report
(a) *Name of firm/individual undertaking valuation
(b) *Registration number issued by IBBI
(c) *Email ID
(d) *Mobile number
(e) *Is valuer, a member of professional body i. e. ICAI, ICSI or
ICWAI(Yes/No)
(f) Membership number of the valuer
(g) Permanent Account Number (PAN)
(h) *Has ICAI issued UDIN against the valuation report(Yes/No/NA)
(i) UDIN of valuation report issued by ICAI
(j) *Method of valuation
(k) *Valuation amount
(l) *Date of issue of report (DD/MM/YYYY)
(m) Other brief details of valuation (if any)
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14. Particulars of private placement
(a) *Category to whom allotment is made
Existing shareholders Employee Directors
Qualified Institutional Buyers Others
(b) If Others, please provide details
15. Particulars of Bonus shares issued
(a) *Class of security
(b) *Number of bonus shares
(c) *Nominal amount per share (in INR)
(d) *Amount to be treated as paid up per share (In INR)
16. *Particulars of securities allotted in case of conversion
(a) *Class of security
(b) *Number of securities allotted
(c) *Nominal amount per security (in INR)
(d) Premium amount per security (in INR
(e) Discount amount per security (in INR)
(f) * Amount to be treated as paid up on each security (in INR )
(g) *Total nominal amount (in INR )
(h) Total premium amount (if any) (in INR )
(i) Total discount amount (if any) (in INR )
17. Details of Conversion
(a)*Brief details of conversion terms
(b)*Value (amount in INR)
(c) In case of preference share, please provide the class of security
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18. *Whether an agreement or contract is executed in writing for allotting securities Yes ●
No
in case of conversion
Particulars Of Agreement/Contract
(a) *Date of agreement
(b) *Parties to agreement
19. Valuation report of security issued
(a) *Whether valuation report of the Registered Valuer has been obtained Yes No
Key information on valuation report
(b) *Name of firm/individual undertaking valuation report
(c) *Registration number issued by IBBI
(d) *Email ID
(e) *Mobile number
(f) *Is valuer, a member of professional body i.e. ICAI, ICSI or ICWAI (Yes/No)
(g) Membership number of the valuer
(h) Permanent Account Number (PAN)
(i) Has ICAI issued UDIN against the valuation report (Yes/No/NA)
(j) UDIN of valuation report issued by ICAI
(k) Method of valuation
(l) Valuation amount per share (in INR)
(m) Date of issue of report (DD/MM/YYYY)
(n) Other brief details of valuation (if any)
(o) Whether shares are issued at a price lower than the price determined by the Yes No
registered valuer?
(p) If Yes, rationale for the same
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Capital structure post allotment
20 Capital structure of the company after taking into consideration the above allotment(s) of shares:
Equity share capital
Number of classes 1
Authorised capital Issued capital Subscribed capital Paid up capital
Class of shares Equity
Number of equity shares 10000 9311 9311 9311
Nominal amount per share (in INR) 10 10 10 10
Total amount of equity shares (in INR) 100000.00 93110.00 93110.00 93110.00
Preference share capital
Number of classes
1
Class of shares Preference Authorised capital Issued capital Subscribed capital Paid up capital
Number of preference shares
10000 1802 1802 1802
Nominal amount per share (in INR)
10 10 10 10
Total amount of preference shares (in INR)
100000.00 18020.00 18020.00 18020.00
Unclassified shares
Particulars Authorised capital
Number of Unclassified shares
0
Total amount of (in INR) Unclassified shares
0
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Capital structure post allotment- Debt
Debt Structure of the company after taking into consideration the above allotment(s) of debentures/ other security:
Particulars Total Amount
Debentures
Secured Loans
Others, specify
Attachments
(a) List of Allottees
List of Allottees.xlsx
Add another attachment
(b) Valuation Report from the valuer, if any
(c) Copy of contract where securities have been allotted for consideration
other than cash or attachment wherein the details of contract reduced in
writing by the company, if any
(d) Optional attachment(s), if any BR_Allottmnt_Prophaze.pdf
List of Allottees_Prophaze_.pdf
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Declaration
I am authorised by the Board of Directors of the Company vide resolution no * 04
dated (DD/MM/YYYY) * 05/12/2024 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. Whatever is stated in this form and in the attachments thereto is true, correct and complete and no
information material to the subject matter of this form has been suppressed or concealed and is as per the original records
maintained by the promoters subscribing to the Memorandum of Association and Articles of Association.
It is further declared and verified that:
1. All the required attachments have been completely, correctly and legibly attached to this form.
2. The list of allottees is correct and complete as per records of the company.
3. Where the securities are issued other than cash, the contract as well as list of allottees and any other contract of sale, or a
contract for services or other consideration in respect of which that allotment is made is attached herewith. If not, then an
attachment has been attached by the company mentioning all the particulars of the contract in writing.
4. The return of allotment in form PAS-2 is not pending for any such allotment of securities, prior to the
date of allotment mentioned in field 6 of the form.
I hereby declare that, in respect of private placement the company has
1. Allotted securities to less than two hundred persons in aggregate in a financial year excluding exempted categories;
2. Offered such securities through private placement offer letter and no prospectus or any other public advertisement has been
issued for the same;
3. Completed allotment in respect of earlier private placement offers;
4. Received money payable on subscription of such securities through cheque or demand draft or other banking channels but not in
cash;
5. Made such offers only to the persons whose names were recorded by the company prior to such invitation and such persons have
received such offer by name;
6. Maintained a complete record of such offers and acceptances in Form No. PAS-5
* To be digitally signed by RAJEEVAN Digitally signed by
RAJEEVAN
DIN1
THOPPIL THOPPIL VAISAKH
Date: 2025.01.23
VAISAKH 12:53:55 +05’30’
08485170
*Designation
Director
(Director/Managing Director/Manager/Company Secretary/CEO/CFO)
*Director identification number of the director; OR DIN or PAN of the manager or 0*4*5*7*
CEO or CFO or Membership number of the Company Secretary
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Certificate by practicing professional
I declare that I have been duly engaged for the purpose of certification of this form. It is hereby certified that I have gone through
the provisions of the Companies Act, 2013 and Rules thereunder for the subject matter of this form and matters incidental thereto
and I have verified the above particulars (including attachment(s)) from the original/certified records maintained by the Company/
applicant which is
subject matter of this form and found them to be true, correct and complete and no information material to this form has been suppressed.
I further certify that:
1. The said records have been properly prepared, signed by the required officers of the Company and maintained as per the relevant
provisions of the Companies Act, 2013 and were found to be in order;
2. All the required attachments have been completely and legibly attached to this form.
I hereby certify that I have gone through the agreements / contracts entered by the Company as applicable for allotment of
securities for consideration other than cash, the details of which have been provided in the form, and found them to be true, correct
and complete and no material information is suppressed.
* To be digitally signed by
DIN2
* Category of professional
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
Certificate of practice number
Note: Attention is drawn to provisions of Section 448 and 449 of the Companies Act, 2013 which provide for punishment for false
statement/certificate and punishment for false evidence respectively.
This eForm has been taken on file maintained by the registrar of companies through electronic mode and on the basis of statement of
correctness given by the filing company.
For office use only:
eForm Service request number (SRN) AB2500335
eForm filing date (DD/MM/YYYY) 23/01/2025
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