FORM NO. 56C

FORM NO. 56C

[See clause (c) of sub-rule (4) of rule 2D]

Statement of assets and liabilities

YEARS

First Year Second Year Third Year

(Mention years also)

A. ASSSETS

1. Fixed assets

 Rs. ................. ......................... ........................

(a) Gross block

 Rs. ................. ......................... ........................

(b) Depreciation

 Rs. ................. ......................... ........................

(c) Net Value (a - b)

 Rs. ................. ......................... ........................

2. Current assets

(a) Investments

 Rs. ................. ......................... ........................

(b) Cash and bank balances Rs. ................. ......................... ........................

(c) Others (Please Specify) Rs. ................. ......................... ........................

(d) Total[(a)+(b)+(c)]

 Rs. ................. ......................... ........................

3. Current liabilities and provisions Rs. ................. ......................... ........................

4. Net worth ( 1 + 2 — 3)

 Rs. ................. ......................... ........................

B. LIAIBTLITIES

1. Monies raised/issued and paid-up capital Rs. ................. ......................... ........................

2. Free reserves (excluding revaluation

reserves)

 Rs. ................. ......................... ........................

3. Total (1 + 2)

 Rs. ................. ......................... ........................

Place :.........................

 .....................................................................................

Date ..........................

 Signature and designation of the applicant

Note: Please give full particulars of investments and also state whether you satisfy the conditions mentioned in

sub-rule (5) of rule 2D, if not, indicate reasons with details.

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FORM NO. 56C (English)

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