1 The number of shares allotted as fully or partly paid-up otherwise than in cash

2 The nominal amount of each such share

Rs.

3 The amount to be considered as paid-up on each share other wise than in cash

Rs.

4 If the consideration for the allotment of such shares is services, or any consideration , other than that mentioned below in (5) state the nature of such consideration, and the number of share so allotted.

5 If the allotment is made in satisfaction or part satisfaction of the purchase price of property, give a brief description of such property, and full particulars of the manner in which the purchase price is to be satisfied

(1) Brief description of property

(2) Purchase price

Rs.

(i) Total amount considered as paid on …………..
shares allotted, otherwise than in cash

Rs.

(ii) Debentures issued

Rs.

(iii) Cash

Rs.

(iv) Amount of debt released or liabilities assumed by the purchaser (including
mortgages on property acquired)

Rs.

• Total purchase price.

Rs.

6 Give full particulars, in the following from of the property which is the subject of the sale, showing in detail how the total purchase price is apportioned between the respective heads:-

• Immovable property held in absolute ownership by the company and fixed plant and machinery and other fixtures thereon
• Leasehold property
• fixed plant and machinery on leasehold property
• (including tenants trade and other fixtures).
• Other interests in immovable property
• Loose plant and machinery stock-in-trade, and other chattels
• Goodwill and benefit or contracts
• patents, designs, trade marks, Licences, copyrights, etc.
• Book and other debts
• Cash in hand and at bank on current account, bills notes, etc.
• Cash on deposit at bank on elsewhere
• Shares, debentures and other investments
• Other, property, viz

Signature

Dated the Day of 19

Designation

1. Where such properties are sold subject to mortgage, the gross value should be shown.

2. Ibid

3. Ibid

4. No plant and machinery which was not in an actual state of severance on the date of the sale should be included under this head.

5 State whether Director, Managing Director, Manager or secretary.