Statement of unclaimed dividends or undistributed assets, paid under sections 555(1) and (2) into the Company's Liquidation Account in the Reserve Bank of India to be furnished under section 555(3)

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....ed assets, paid under sections 555(1) and (2) into the Company's Liquidation Account in the Reserve Bank of India to be furnished under section 555(3) Name of the company.......................................... Nature of the proceeding[1].......................................... Date of commencement of winding-up............................ Date of payment into the Company's Liquidation Acc....

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....when payable Account Amount paid into Company's Liquidation Remarks 1 2 3 4 5 6 7 8 9 TOTAL ---------------- Rs. P. Total amount of unclaimed dividends paid into the Company's Liquidation Account Total amount of undistributed assets paid into the Company's Liquidation Account Total amount paid under both heads (Sd.) Dated the .............. day of ............. 19....... Liquidat....