Company Law Board Regulations, 1991
FORM NO.4
(See Regulation 37)
APPLICATION BY DEPOSITOR UNDER SECTION 58A (9) OF THE ACT OR SECTION 45QAOF THE RESERVE BANK OF INDIA ACT, 1934 (*delete whichever is not applicable)
BEFORE THE COMPANY LAW BOARD ( BENCH)
IN THE MATTER OFN THE COMPANIES ACT, 1956 ( 1 OF 1956), (SECTION 58A 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 Deposits\:
v. Fixed Deposit Receipt No. & 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, abovenamed 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. (ii)that such further orders be passed as the Company Law Board may deed fit in the circumstances of the case.
(Signature of the Depositor-applicant)
Place: ..
Date: ...
Note :
1. The application shall be accompanied by a fee of Rupees Fifty, by way of Bank Draft in favour of The Pay and Accounts Officer, Department of Company Affairs, New Delhi/ Bombay/ Calcutta/ Madras
2. This application shall be made in duplicate.