TaxTMI 
TaxTMI 
Application for registration as an insolvency professional - Regulation 6- Insolvency Professionals
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.... Title (Mr. / Mrs. / Ms. / Other): 2. Name (as per PAN / Aadhaar): 3. Father's Name: 4. Mother's Name: 5. Date of Birth: 6. Place of Birth: 7. PAN: 8. AADHAAR No. (if available): 9. Passport No. (if available): 10. GSTIN (if available): 11. DIN / DPIN (if available): 12. Address for Correspondence (Note: This shall be recorded as the registered address): 13. Permanent Address: 14. E-mail Address (Note: This shall be recorded as the registered e-mail address): 15. Mobile No. (Note: This shall be recorded as the registered mobile number): 16. Residential Status: Person resident in India/ Person resident outside India (strike off whichever is not applicable) [in terms of section 3 (24) or 3 (25) of Insolvency and Bankruptcy Code, 2016] B. EDUCATIONAL, PROFESSIONAL AND INSOLVENCY EXAMINATION QUALIFICATIONS (i) Educational Qualifications [Please provide educational qualifications from Bachelor's degree onwards] Sl. No. Educational qualification University /College Year of Passing Marks Secured (%) Grade/ Class Remarks, if any (1) (2) (3) (4) (5) (6) (7) (ii) Professional Qualifications [in terms of regulation 5(c)(iv) of IP Regulations] Sl. No.....
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....cable Date of Rejection, if applicable 6. Please provide any additional information that may be relevant for determining fit and proper person eligibility. E. ATTACHMENTS 1. Copy of proof of residence 2. Copy of PAN card, Aadhaar card and Passport 3. Copy of GST Registration Certificate 4. Copy of DIN/ DPIN allotment letter 5. Copies of documents in support of educational qualification, professional qualification, and insolvency examination. 6. Copies of documents demonstrating practice as - (i) a chartered accountant registered with the Institute of Chartered Accountants of India; (ii) a company secretary registered with the Institute of Company Secretaries of India; (iii) a cost accountant registered with the Institute of Cost Accountants of India; or (iv) an advocate enrolled with the Bar Council. 7. Copies of certificate of employment from the employer(s), specifying the period of such employment 8. Financial statements / Income-tax Returns for the last three years. 9. Copy of certificate of professional membership of Registered Valuer Organisation. 10. Evidence of deposit / payment of applicable fee. 11. Details of information with respect to conviction, crim....
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.... of application seeking enrolment with the Insolvency Professional Agency? (Yes/No) E. AFFIRMATIONS I affirm that I am eligible to be registered as an insolvency professional under the Insolvency and Bankruptcy Board of India (Insolvency Professionals) Regulations, 2016 read with section 207 of the Insolvency and Bankruptcy Code, 2016. 2. I affirm that the information furnished by me in this application is correct and complete to the best of my knowledge and belief. 3. I undertake to comply with the requirements of the Insolvency and Bankruptcy Code, 2016, rules, regulations, guidelines and circulars issued thereunder, the bye-laws of the insolvency professional agency with which I am enrolled and directions given by the Board and the Governing Board of such insolvency professional agency and to furnish any additional information as and when called for by the Board or Insolvency Professional Agency. F. ATTACHMENTS 1. Copy of certificate of membership with an insolvency professional agency. 2. Copy of certificate of completion of pre-registration educational course. 3. Evidence of deposit / payment of applicable fee. 4. Copy of proof towards information updated in the Form ....
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....s been furnished by the professional member, whether the status thereof has been verified along with nature of designation held by the professional member? Yes / No. If Yes, give details and supporting document. 8 Whether the name of the professional member appears in the database of Ministry of Corporate Affairs regarding: i. Directors disqualified under section 164 of the Companies Act, 2013, or ii. Proclaimed Offenders under section 82 of the Code of Criminal Procedure, 1973. Yes / No. If Yes, give details and supporting document. 9 Whether the professional member has been penalised by SEBI or CCI in the last three years? Yes / No. If Yes, give details and supporting document. 10 Whether the name of professional member appears in the list of defaulters of RBI / Credit Information Company? Yes / No. If Yes, give details and supporting document. 11 Whether the professional member has been convicted of any offence? Yes / No. If Yes, give details and supporting document. We have verified the above details submitted by who is our professional member with and confirm these to be true and correct. We recommend registration of as an insolvency professional with IBB....
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....tice If employed, Name of Employer and Designation If in practice, practice as Advocate/Chartered Accountant/Company Secretary/Cost Accountant Area of work D. INSOLVENCY PROFESSIONAL AGENCY 1. Please give details of the insolvency professional agency with which you are enrolled as a professional member. 2. Please state your professional membership number. E. ADDITIONAL INFORMATION 1. Have you ever been convicted for an offence? Yes/ No. If yes, please give details. 2. Are any criminal proceedings pending against you? (Yes/ No) If yes, please give details. 3. Have you ever been declared as an undischarged insolvent, or applied to be declared so? (Yes/ No) If yes, please give details. 4. Please provide any additional information that may be relevant for your application. F. ATTACHMENTS 1. Copy of proof of residence. 2. Copies of documents in support of educational qualifications, professional qualification and insolvency examination qualifications. 3. Copies of documents demonstrating practice as - i. a chartered accountant enrolled with the Institute of Chartered Accountants of India; ii. a company secretary enrolled with the Institute of Company Secretaries of....
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....(IP Division) Insolvency and Bankruptcy Board of India Subject: Application for registration as an insolvency professional Sir / Madam, I, having been enrolled as a professional member with the ____(please write the name of the insolvency professional agency), hereby apply for registration as an insolvency professional under section 207 of the Insolvency and Bankruptcy Code, 2016 read with regulation 6 of the Insolvency and Bankruptcy Board of India (Insolvency Professionals) Regulations, 2016. My details are as under: A. PERSONAL DETAILS 1. Title (Mr./Mrs/Ms.): 2. Name: 3. Father's Name: 4. Date of Birth: 5. Place of Birth: 6. PAN No.: 7. AADHAAR No. (if available): 8. Passport No. (if available): 9. Address for Correspondence: 10. Permanent Address: 11. E-Mail Address: 12. Mobile No.: B. EDUCATIONAL, PROFESSIONAL AND INSOLVENCY EXAMINATION QUALIFICATIONS 1. Educational Qualifications [Please provide educational qualifications from Bachelor's degree onwards] Educational Qualification Year of Passing Marks (%) Grade/ Class University/College Remarks, if any 2. Professional Qualifications Professional Qualification Institute/ Professional Body Me....
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....hree years. 6. Copy of certificate of professional membership with an insolvency professional agency. 7. Passport-size photo. 8. Evidence of deposit / payment of five thousand rupees / ten thousand rupees, as applicable. G. AFFIRMATIONS 1. Copies of documents, as listed in section F of this application form have been attached/ uploaded. The documents attached/ uploaded are …… I undertake to furnish any additional information as and when called for. 2. I am not disqualified from being registered as an insolvency professional under the Insolvency and Bankruptcy Board of India (Insolvency Professionals) Regulations, 2016. 3. I hereby certify and declare that I am not an undischarged insolvent/bankrupt and have not made any application to be adjudged so under the laws of any jurisdiction. 4. This application and the information furnished by me along with this application is true and complete. If found false or misleading at any stage, my registration shall be summarily cancelled. 5. I hereby undertake to comply with the requirements of the Insolvency and Bankruptcy Code, 2016, the rules, regulations, guidelines and circulars issued thereunder, the bye-laws of t....
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....09-2023 before it was read as, "2[FORM A [Under regulation 6 of the Insolvency and Bankruptcy Board of India (Insolvency Professionals) Regulations, 2016] To The Executive Director (IP Division) Insolvency and Bankruptcy Board of India Subject: Application for registration as an insolvency professional. Sir / Madam, I, having been enrolled as a professional member with the [name of the insolvency professional agency] on [date of enrolment] with [professional membership number], hereby apply for registration as an insolvency professional under section 207 of the Insolvency and Bankruptcy Code, 2016 read with regulation 6 of the Insolvency and Bankruptcy Board of India (Insolvency Professionals) Regulations, 2016 [IP Regulations]. My details are as under: A. PERSONAL DETAILS 1. Title (Mr. / Mrs. / Ms. / Other): 2. Name (as per PAN / Aadhaar): 3. Father's Name: 4. Mother's Name: 5. Date of Birth: 6. Place of Birth: 7. PAN: 8. AADHAAR No. (if available): 9. Passport No. (if available): 10. GSTIN (if available): 11. DIN / DPIN (if available): 12. Address for Correspondence (Note: This shall be recorded as the registered address): 13. Permanent Address: 14....
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....umber, if applicable (1) (2) (3) (4) (5) (6) (7) (8) D. ADDITIONAL INFORMATION 1. Have you ever been convicted of an offence? (Yes / No) If yes, please give complete details along with current status. 2. Is any criminal proceeding pending against you? (Yes / No) If yes, please give complete details along with current status. 3. Have you ever been adjudged as a bankrupt? (Yes / No.) If yes, please give complete details along with current status. 4. Is there any disciplinary proceeding pending against you or has been taken against you at any time in the preceding three years by the ICAI, ICSI, ICAI (Cost), Bar Council or RVO? (Yes / No) If yes, please give complete details along with current status. 5. Please provide any additional information that may be relevant for determining if you are fit and proper person. AFFIRMATION I affirm that I am eligible to be registered as an insolvency professional under the Insolvency and Bankruptcy Board of India (Insolvency Professionals) Regulations, 2016 read with section 207 of the Insolvency and Bankruptcy Code, 2016. 2. I affirm that the information furnished by me in this application is correct and complete to the....