Declaration
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 including the attachments to this form and nothing material has been suppressed.
To be digitally signed by
*Designation
*Director identification number of the director or Managing
Director; or DIN or PAN of the manager/CEO/CFO; or
Membership number of the Company Secretary
FORM PAS. 3
Return of Allotment
[Pursuant to section 39(4) and 42(9) of the Companies Act,2013 and rule 12 and 14 of Companies (Prospectus andAllotment of Securities) Rules, 2014]
Form Language
English
Hindi
Refer the instruction kit for filing the form.
1.
(a) *Corporate Identification Number (CIN) of company
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| (b) Global Location number (GLN) of company
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| (a) Name of the company
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| (b) Address of Registered office of the company
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| (c) email id of the company
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3
Securities allotted payable in cash
*Number of allotments
(i) *Date of allotment
(DD/MM/YY)
(ii) (a) Date of passing shareholders' resolution
(b) SRN of Form No MGT-14
Particulars
Preference shares
Equity shares without Differential rights
Equity Shares with differential rights
Debentures
Brief particulars of terms and conditions
Number of securities allotted
Nominal amount per security (in Rs.)
Total nominal amount (in Rs.)
Amount paid per security on application
(excluding premium) (in Rs.)
Total amount paid on application (excluding
premium) (in Rs.)
Amount due and payable on allotment per security
(excluding premium) (in Rs.)
Total amount payable on allotment (excluding
premium) (in Rs.)
Premium amount per security due and payable (if
any) (in Rs.)
Total premium amount due and payable (if any)
(in Rs.)
Premium amount paid per security (if any) (in
Rs.)
Total premium amount paid (if any) (in Rs.)
Amount of discount per security (if any)(in Rs.)
Total discount amount (if any) (in Rs.)
Amount to be paid on calls per security (if any)
(excluding premium) (in Rs.)
Total amount to be paid on calls (if any)
(excluding premium) (in Rs.)
4.
Securities allotted for consideration other than cash
*Number of allotments
(i) *Date of allotment
(DD/MM/YY)
(ii) (a) Date of passing shareholders' resolution
(b) SRN of Form No MGT-14
Particulars
Preference shares
Equity shares without Differential rights
Equity Shares with differential rights
Debentures
Number of securities allotted
Nominal amount per security (in Rs.)
Total nominal amount (in Rs.)
Amount to be treated as paid up on each security
(in Rs.)
Premium amount per security (if any) (in
Rs.)
Total premium amount paid (if any) (in Rs.)
Amount of discount per security (if any)(in Rs.)
Total discount amount (if any) (in Rs.)
(iv) *Details of consideration
Consideration for which such securities have been
allotted
Description of the consideration
Value (amount in Rs.)
(a) Property and assets acquired
(b) Goodwill
(c) Services (give nature of services)
(d) Conversion of Debentures
(e ) Conversion of Loans
(f) Other items (to be specified)
(v) *Whether an agreement or contract is executed
in writing for allotting securities for consideration other than
cash (if yes, attach a copy of such agreement or contract).
Yes
No
(vi) Whether valuation report of the Valuer has
been obtained.
Yes
No
5
Bonus shares issued
(a) Date of allotment
(b) Number of bonus shares
(c) Nominal amount per share (in Rs.)
(d) Amount to be treated as paid up per share (in Rs.)
(e) *Date of passing special resolution
(f) *SRN of relevant form relating to special resolution