Company Form No. 22.

No. of shares

Nominal value of each share

Cash received up to

(a)

Allotted subject to payment thereof in cash.

(i) Equity

(ii) Redeemable preference shares.

(iii) Preference shares other than redeemable

preference shares.

(b)

Allotted as fully paid up otherwise than in cash and the consideration for which they have been allotted.

(i) Equity

(ii) Redeemable preference shares

(iii) Preference shares other than redeemable

preference shares.

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Allotted as party paid up to the extent of Rs. ……….. per share and the consideration for which they have been so allotted.

(i) Equity

(ii) Redeemable preference shares

(iii) Preference shares other than redeemable preference shares

2. Abstract of receipts and payments upto:--

Receipts Rs.

Payments Rs.

Shares

Preliminary expenses

Equity

Commission on issue or

Redeemable preference shares.

Sale of shares…………………….

Preference shares other than.

Discount on issue or

redeemable preference shares.

Sale of shares……………………..

Advance payment for shares.

Capital expenditure

Debentures …………………………….

Land ……………………………..

Loans ………………………………….

Building ………………………….

Deposits ……………………………….

Plant ……………………………..

Other sources ………………………….

Machinery……………………….

(to be specified) ……………………….

Other items to be specified

Balances………………………………….

In hand ……………………………

At banks …………………………..

At post Office …………………….

Saving Bank ………………………

Total

Total

3. Preliminary expense as estimated in the prospectus or statement in the lieu of
prospectus …………………………………..

preliminary expenses actually incurred up to aforesaid date Rs.

Preliminary expenses estimated to be incurred after the aforesaid date Rs.

Law carges……………………………………

Other charges in connection with the preparation of the Memorandum

Articles of Association ………………………

printing expenses ……………………………

Registration charges …………………………

Advertisement charges ………………………

Commission on issue or sale of shares

……………………………………………..

Discount on issue or sale of shares……………

Other initial expenses.(To be specified as far as possible ).

Total Rs. ………………………………………

4. Names, addresses and occupation of the company’s Directors, Auditors, Manager and Secretary.

Name(s)

Address(es)

Occupation(s)

Particulars of change(s) if any, in entries in columns (1), (2) and (3) since the date of incorporation

Date of the change

1

2

3

4

5

A.

Directors

B.

Auditors

C.

[***]

D.

Manager

E.

Secretary

These Particulars must include dates of changes.

5. Particulars of any contract which is to be submitted to the statutory meting for approval. (If any modification or proposed modification of a contract is to be submitted for such approval, brief particulars of contract and particulars of modification or proposed modification should be given).

6. Underwriting contracts.

Brief description of each contract.

If contract not carried out fully, extent to which it has not been carried out and reason thereby.

7. The arrears, if any, due on calls from Directors, [***]

Names

Amount due

Directors

Manager

8.Particularts of any commission or brokerage paid or to be paid in connection with the issue or sale of shares to any director or Manager.

Names

Commission or brokerage paid or to be paid

On shares

On debentures

Directors

Manager.