Form No. 4 : 25[Application by depositor *under section 58A(9) of the Act or section 45QA of the Reserve Bank of India Act, 1934]
(See regulation 37)
Before the Company Law Board ( _________________________ Bench)
In the matter of the Companies Act, 1956, section 58A 5[of the Act or section 45QA of the Reserve Bank of India Act, 1934]
and
In the matter of (state the name of the Depositor-applicant)
and
In the matter of ____________________________________ Limited
(state the name of the company)
(i) Name and address of the Depositor-applicant;
(ii) Name of the company and address of its Registered Office;
(iii) Name(s) of depositor(s) with full address;
(iv) Amount of Deposit;
(v) Fixed Deposit Receipt No. and Date (Photostat copy to be enclosed);
(vi) Terms and conditions of deposit as also date of maturity of deposit;
(vii) Details of payment made, by the company, if any;
(viii) Actual amount due as on date of application (Principal/Interest);
(ix) Details of correspondence, if any, made between the company and the depositor (copy of correspondence to be enclosed);
(x) Any other particular(s) as may be considered relevant;
The Depositor-applicant therefore, prays:-
(i) that the company, above-named be directed to make repayment of the aforesaid deposit(s) along with interest due thereon in accordance with the terms and conditions of the deposit;
(ii) that such further orders be passed as the Company Law Board may deem fit in the circumstances of the case.
(Signature of the Depositor-applicant)
Place _______________
Date _______________
*Delete whichever is not applicable.
Notes:
1. The application shall be accompanied by a fee of Rupees Fifty by way of Bank Draft in favor of The Pay and Accounts Officer, Department of Company Affairs, New Delhi/Bombay/Calcutta/Madras.
2. This application shall be made in duplicate.
