Statement of assets and liabilities

Details Year1 Year2 Year3

Assets

1. Fixed Assets

1. Gross block

2. Depreciation

3. Net value a-b.

2. Current Assets.

1. Investments

2. Cash and bank balances

3. Others please specify.

4. Total a+b+c.

1. Current liabilities and provisions.

2. Net worth 1+2-3.

Liabilities

1. Money is raised or issued and paid-up capital.

2. Free Reserves excluding revaluation reverse.

3. Total 1+2.

Place _____

Date ______

Signature and designation of the applicant.

Note: Please give full particulars of investments shall also state that whether they satisfy the conditions in sub rule5 of rule 2D. If not indicate reasons with details.

Action points: This form must accompany with the form 56A