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8/12/2019 Annual Return Susruta 2012
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3 L I S T E N C L O S E D
V. DIRECTORS/MANAGER/SECRETARY INFORMATION ( PAST AND PRESENT)*(Refer Clause 6 of Part 1 of Schedule v given below) enclosed
NameSurname Middle Name First Name
Nationality I I - Indian Date of Birth -- --F - Foreign Date Month Year
Designation C - Chairman-cum-Managing DirectorW - Whole Time Director, S - Secretary, R - Manager MD - Director, M - Managing Director
Date of -- -- Date of -- --Appointment Date Month Year Ceasing Date Month Year
Election Commission Identity Card No.(if issued)
Name Surname Middle Name First Name
Nationality I I - Indian Date of Birth -- --
F - Foreign Date Month Year
Designation C - Chairman-cum-Managing DirectorW - Whole Time Director, S - Secretary, R - Manager DD - Director, M - Managing Director
Date of -- -- Date of -- --Appointment Date Month Year Ceasing Date Month Year
Election Commission Identity Card No.(if issued)
NameSurname Middle Name First Name
Nationality I - Indian Date of Birth -- --F - Foreign Date Month Year
Designation C - Chairman-cum-Managing DirectorW - Whole Time Director, S - Secretary, R - ManagerD - Director, M - Managing Director
Date of -- -- Date of -- --Appointment Date Month Year Ceasing Date Month Year
ect on omm ss on ent ty ar o. ssue
* Clause 6 of Part I of Schedule v - Particulars specifying name, nationality, date of birth , date of appointment, Election commission's Identity
Card No., if issued,and residential address with respect to the persons who at the date of the company's last annual general meeting are thedirectors of the company and with respect to any person who at the date is the manager or the secretary of the company together with allsuch particulars, with respect to those who had ceased to hold such office that is the office of director, manager or secretary on or before thedate of the last annual general meeting and since the date of the annual general meeting with respect to which the last return was submittedor in the case of the first return, since the incorporation of the company.
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4 L I S T E N C L O S E D
V. DIRECTORS/MANAGER/SECRETARY INFORMATION ( PAST AND PRESENT)*(contd.)
RESIDENTIAL ADDRESS
Town/City
District
State
PIN Code
RESIDENTIAL ADDRESS
Town/CityDistrict
tatePIN Code
RESIDENTIAL ADDRESS
Town/Citystr cttate
PIN CodeNOTE - Additional sheets may be attached if needeed
V. DETAILS OF SHARES / DEBENTURES HELD AT DATE OF AGM* enclosed
Ledger Folio of Share / Debenture holder
Share / Debenture Holder's NameSurname Middle Name First name
Father's / Husband's Name
Type of Share / Debenture 1 - Equity 2 - Preference Shares 3 - Debentures 4 - Stock
Number of Shares /Debentures Held / Amount per ShareStock , if Any ( in Rs.)
Ledger Folio of Share / Debenture holder
Share / Debenture Holder's NameSurname Middle Name First name
Father's / Husband's Name
Type of Share / Debenture 1 - Equity 2 - Preference Shares 3 - Debentures 4 - Stock
Number of Shares /e entures e mount per are
Stock , if Any ( in Rs.)
* NOTE - Separate sheet may be attached if needed. If number of such shareholders exceed. 10,if so desired a text file may be submitted on afloppy or a cartridge tape in the format given in Annexure - III
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5 L I S T E N C L O S E DV. DETAILS OF SHARES / DEBENTURES HELD AT DATE OF AGM( Contd.)
Ledger Folio of Share / Debenture holder
Share / Debenture Holder's NameSurname Middle Name First name
at er s us an s ame
Type of Share / Debenture 1 - Equity 2 - Preference Shares 3 - Debentures 4 - Stock
Number of Shares /Debentures Held / Amount per ShareStock , if Any ( in Rs.)
ADDRESS
own ys r c
tate o e
own ys r c
o e
s r c
VI. DETAILS OF SHARES / DEBENTURES TRANSFERS SINCE DATE OF LAST AGM
( or in the case of the first return at any time since the incorporation of the company )*Date of Previous AGM 3 0 -- 0 9 -- 2 0 1 1
Date Month Year
Date of Registration of Transfer of SharesDate Month Year
Type of Transfer 1 - Equity 2 - Preference Shares 3 - Debentures 4 - Stock
Number of Shares / Debentures Transferred Amount per Share (in Rs.)e ger o o o rans eror
Transferor's Nameurname e ame rs ame
Ledger Folio of Transfereerans eree s ame
urname e ame rs ame* NOTE - Separate sheet may be attached if needed. If number of such shareholders exceed. 10,if so desired a text file may be submitted on a
floppy or a cartridge tape in the format given in Annexure - IV
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VI. DETAILS OF SHARES / DEBENTURES TRANSFERS SINCE DATE OF LAST AGM(Contd.)
Date of Registration of Transfer of SharesDate Month Year
Type of Transfer 1 - Equity 2 - Preference Shares 3 - Debentures 4 - Stock
Number of Shares / Debentures Transferred Amount per Share (in Rs.)
Ledger Folio of Transferor
Transferor's NameSurname Middle Name First Name
Ledger Folio of Transferee
Transferee's NameSurname Middle Name First Name
VII. INDEBTEDNESS OF THE COMPANY ( AMOUNT IN RS. THOUSANDS)[Secured loans including interest outstanding / accrued but not due for payment ]
Amount (in Rs.) 4 7 6 0 . 3
VIII.EQUITY SHARE CAPITAL BREAKUP(PERCENTAGE OF TOTAL EQUITY)
(I) Govt. [Central & State(s) (ii) Govt. Companies(iii) Public Financial Institutions (iv) Nationalised/other banks
(v) Mutual Funds (vi) Venture Capital
(vii) Foreign Holdings (viii) Bodies Corporate (FIIs/FCs/FFIs NRIs/OCBs) (Not mentioned above)
(ix) Directors/ Relatives of Directors 1 0 0 (x) Other top 50 Shareholders(Other than those listed above)
We certify that :-(a) the return states the facts as they stood on the date of the Annual General Meeting aforesaid, correctly and completely;(b) since the date of the last annual return the transfer of all shares, debentures, the issue of all further certificates of shares
and debentures, have been appropriately recorded in the books maintained for the purpose; the whole of the amount of dividend remaining unpaid or unclaimed for a period of three years from the date of transfer to
the special account been transferred to the General Revenue Account of the Central Government as required undersub-section (5) of Section 205-A :
(d) the company has not, since the date of annual general meeting with reference to which the last return was submitted, or inthe case of a first return , since the date of the incorporationof the company, issued any invitation to the public to subscribefor any shares or debentures of the company;
(e) where the annual return discloses the fact that the number of members of the company exceeds fifty, the excess consists wholly or persons who under sub-clause (1) of Section 3 are not to be included in the reckoning the number of fifty;
(f) since the date of annual general meeting with reference to which the first return was submitted or in the case of a firstreturn since the date of the incorporation of the private company, or public company or deemed public company has or
have held twenty-five percent, or more of its paid-up share capital;(g) the company did not have an average turnover of Rs.Ten Crores or more during the relevant period;(h) since the date of the annual general meeting with reference to which the last annual return was submitted or since the
date of incorporation of the company, if it is first return, the company did not hold Twenty-five percent or more of the paid-up share capital of one or more public companies; and
(I) the private company did not accept or renew or invite deposits from the public.
s gne Director V. J AM E S PO NN AI YA NDirector/managing Director/manager/secretary : R. M O W L E E S W A R
Secretary in whole time practice : .CP No : .
NOTE - Certificates to be given by a Director and Manager/Secretary or by Two Directors where there is no manger or Secretary.In thecase o a company w ose s ares are s e on a recogn se oc xc ange , e cer ca es a a so e s gne y a ecre ary n
Whole time practice.
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