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Resolute _ Dcirrus-2022.pdf

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Rakesh Bhagwan Shinde submits a claim for Rs. 16,200 against Pancard Clubs Limited, which is undergoing corporate insolvency resolution. He provides his name, identification details, address, bank account details, and attaches supporting documents including a slip and certificate to substantiate the debt incurred on October 31, 2009. Shinde declares that to the best of his knowledge, the claim and supporting documents are true and that he has not received any security or satisfaction against the claimed amount.

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FORM CA SUBMISSION OF CLAIM BY FINANCIAL CREDITORS IN A CLASS (Under Regulation 8A of the Insolvency and Bankruptcy (Insolvency Resolution Process for Corporate Persons) Regulations, 2016) From RAKESH BHAGWAN SHINDE Date 27/9/2022 606 JASWANDI A 9 SAROVAR DARSHAN CO OP SOC CHANDAWADI RAIGAD LANE ALMEDA ROAD THANE WEST 400602 To The Interim Resolution Professional / Resolution Professional Rajesh Sureshchandra Sheth Registered Address: B-55, Shatdal Society, 7th Floor, Azad Lane, Off S.V. Road, Andheri West, Near Shoppers Stop, Mumbai 400058, Maharashtra Correspondence Address: Deloitte India Insolvency Professionals LLP, 27th Floor, Tower 3, One International Center, Senapati Bapat Marg, Elphinstone (W), Mumbai 400 013 Subject: Submission of claim and proof of claim. Madam/Sir, RAKESH BHAGWAN SHINDE, hereby submits this claim in respect of the corporate insolvency resolution process of Pancard Clubs Limited. The details for the same are set out below: RELEVANT PARTICULARS 1. Name of the financial creditor RAKESH BHAGWAN SHINDE 2. Identification number of the financial creditor (If an incorporated body, provide identification number and proof of incorporation. If a partnership or individual, provide identification records of all the partners or the individual) BLMPS4810G 3. Address and e-mail address of the financial creditor for correspondence. 606 JASWANDI A 9 SAROVAR DARSHAN CO OP SOC CHANDAWADI RAIGAD LANE ALMEDA ROAD THANE WEST 400602, rakeshshinde181980@gmail.com 4. Total amount of claim (in Rs.) 16200 5. Details of documents by reference to which the debt can be substantiated. SLIP AND CERTIFICATE 6. Details of how and when debt incurred. 31 OCBOBER 2009 7. Details of any mutual credit, mutual debts, or other mutual dealings between the corporate debtor and the creditor which may be set-off against the claim. NA 8. Details of any security held, the value of the security, and the date it was given NA 9. Details of the bank account to which the amount of the claim or any part thereof can be transferred pursuant to a resolution plan BANK ACCOUNT NO 008110100020702 IFSC CODE TJSB0000008 10. List of documents attached to this claim in order to prove the existence and non-payment of claim due SLIP AND CERTIFICATE 11. Name of the insolvency professional who will act as the Authorised representative of creditors of the class Mr. Vithal Madhukar Dahake
Signature of financial creditor or person authorised to act on its behalf [Please enclose the authority if this is being submitted on behalf of the financial creditor] Name in BLOCK LETTERS : RAKESH BHAGWAN SHINDE Position with or in relation to creditor :SELF Address of person signing : 06 JASWANDI A 9 SAROVAR DARSHAN CO OP SOC CHANDAWADI RAIGAD LANE ALMEDA ROAD THANE WEST 400602 *PAN number, passport, AADHAAR Card or the identity card issued by the Election Commission of India. DECLARATION I, RAKESH BHAGWAN SHINDE, currently residing at 606 JASWANDI A 9 SAROVAR DARSHAN CO OP SOC CHANDAWADI RAIGAD LANE ALMEDA ROAD THANE WEST 400602 , do hereby declare and state as follows: - 1. Pancard Clubs Limited, the corporate debtor was, at the insolvency commencement date, being the 9th day of September 2022, actually indebted to me for a sum of Rs.16200 2. In respect of my claim of the said sum or any part thereof, I have relied on the documents specified below: SLIP AND CERTIFICATE. 3. The said documents are true, valid and genuine to the best of my knowledge, information and belief and no material facts have been concealed therefrom. 4. In respect of the said sum or any part thereof, neither I, nor any person, by my order, to my knowledge or belief, for my use, had or received any manner of satisfaction or security whatsoever, save and except the following: NA 5. I ama related party of the corporate debtor, as defined under section 5 (24) of the Code. 6. I am eligible to give voting instruction to the authorized representative by virtue of proviso to section 21 (2) of the Code even though I am a related party of the corporate debtor. Date : Place : (Signature of the claimant) VERIFICATION I, RAKESH BHAGWAN SHINDE the claimant hereinabove, do hereby verify that the contents of this proof of claim are true and correct to my knowledge and belief and no material fact has been concealed therefrom. Verified at on this day of , 20 (Signature of claimant) [Note: In the case of company or limited liability partnership, the declaration and verification shall be made by the director/manager/secretary/designated partner and in the case of other entities, an officer authorized for the purpose by the entity.] [Note: After downloading the filled in Form, the Upload & Claim Button is enabled for users.] [Note: Before clicking Upload and Claim, please make sure to upload all necessary documents. Once the claim has been uploaded, you won't be able to update any data or upload any documents.]

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Resolute _ Dcirrus-2022.pdf

  • 1. FORM CA SUBMISSION OF CLAIM BY FINANCIAL CREDITORS IN A CLASS (Under Regulation 8A of the Insolvency and Bankruptcy (Insolvency Resolution Process for Corporate Persons) Regulations, 2016) From RAKESH BHAGWAN SHINDE Date 27/9/2022 606 JASWANDI A 9 SAROVAR DARSHAN CO OP SOC CHANDAWADI RAIGAD LANE ALMEDA ROAD THANE WEST 400602 To The Interim Resolution Professional / Resolution Professional Rajesh Sureshchandra Sheth Registered Address: B-55, Shatdal Society, 7th Floor, Azad Lane, Off S.V. Road, Andheri West, Near Shoppers Stop, Mumbai 400058, Maharashtra Correspondence Address: Deloitte India Insolvency Professionals LLP, 27th Floor, Tower 3, One International Center, Senapati Bapat Marg, Elphinstone (W), Mumbai 400 013 Subject: Submission of claim and proof of claim. Madam/Sir, RAKESH BHAGWAN SHINDE, hereby submits this claim in respect of the corporate insolvency resolution process of Pancard Clubs Limited. The details for the same are set out below: RELEVANT PARTICULARS 1. Name of the financial creditor RAKESH BHAGWAN SHINDE 2. Identification number of the financial creditor (If an incorporated body, provide identification number and proof of incorporation. If a partnership or individual, provide identification records of all the partners or the individual) BLMPS4810G 3. Address and e-mail address of the financial creditor for correspondence. 606 JASWANDI A 9 SAROVAR DARSHAN CO OP SOC CHANDAWADI RAIGAD LANE ALMEDA ROAD THANE WEST 400602, rakeshshinde181980@gmail.com 4. Total amount of claim (in Rs.) 16200 5. Details of documents by reference to which the debt can be substantiated. SLIP AND CERTIFICATE 6. Details of how and when debt incurred. 31 OCBOBER 2009 7. Details of any mutual credit, mutual debts, or other mutual dealings between the corporate debtor and the creditor which may be set-off against the claim. NA 8. Details of any security held, the value of the security, and the date it was given NA 9. Details of the bank account to which the amount of the claim or any part thereof can be transferred pursuant to a resolution plan BANK ACCOUNT NO 008110100020702 IFSC CODE TJSB0000008 10. List of documents attached to this claim in order to prove the existence and non-payment of claim due SLIP AND CERTIFICATE 11. Name of the insolvency professional who will act as the Authorised representative of creditors of the class Mr. Vithal Madhukar Dahake
  • 2. Signature of financial creditor or person authorised to act on its behalf [Please enclose the authority if this is being submitted on behalf of the financial creditor] Name in BLOCK LETTERS : RAKESH BHAGWAN SHINDE Position with or in relation to creditor :SELF Address of person signing : 06 JASWANDI A 9 SAROVAR DARSHAN CO OP SOC CHANDAWADI RAIGAD LANE ALMEDA ROAD THANE WEST 400602 *PAN number, passport, AADHAAR Card or the identity card issued by the Election Commission of India. DECLARATION I, RAKESH BHAGWAN SHINDE, currently residing at 606 JASWANDI A 9 SAROVAR DARSHAN CO OP SOC CHANDAWADI RAIGAD LANE ALMEDA ROAD THANE WEST 400602 , do hereby declare and state as follows: - 1. Pancard Clubs Limited, the corporate debtor was, at the insolvency commencement date, being the 9th day of September 2022, actually indebted to me for a sum of Rs.16200 2. In respect of my claim of the said sum or any part thereof, I have relied on the documents specified below: SLIP AND CERTIFICATE. 3. The said documents are true, valid and genuine to the best of my knowledge, information and belief and no material facts have been concealed therefrom. 4. In respect of the said sum or any part thereof, neither I, nor any person, by my order, to my knowledge or belief, for my use, had or received any manner of satisfaction or security whatsoever, save and except the following: NA 5. I ama related party of the corporate debtor, as defined under section 5 (24) of the Code. 6. I am eligible to give voting instruction to the authorized representative by virtue of proviso to section 21 (2) of the Code even though I am a related party of the corporate debtor. Date : Place : (Signature of the claimant) VERIFICATION I, RAKESH BHAGWAN SHINDE the claimant hereinabove, do hereby verify that the contents of this proof of claim are true and correct to my knowledge and belief and no material fact has been concealed therefrom. Verified at on this day of , 20 (Signature of claimant) [Note: In the case of company or limited liability partnership, the declaration and verification shall be made by the director/manager/secretary/designated partner and in the case of other entities, an officer authorized for the purpose by the entity.] [Note: After downloading the filled in Form, the Upload & Claim Button is enabled for users.] [Note: Before clicking Upload and Claim, please make sure to upload all necessary documents. Once the claim has been uploaded, you won't be able to update any data or upload any documents.]