FORM No. STK -4
AFFIDAVIT
(to be given individually by every Director) [Pursuant to sub section (2) of section 248 read with clause (iii) of sub-rule (3) of Rule 4]
———————————————————————-
1. I/ We ……………. Director of………………. (hereinafter called “the Company”), incorporated on …………….. under the Companies Act, 2013 or the Companies Act, 1956 having its registered office at…………………. and having CIN …………… do solemnly affirm and state as under:
(i) I/ We …………….. S/o / D/o Shri/Smt……………. Holder of DIN/Income Tax PAN/Passport number ………………….. (copy of Income Tax PAN/Passport duly attested by a Gazetted Officer or a whole time practicing professional viz Chartered Accountant/Company Secretary/Cost Accountant) am Director of the Company stated above since………. (mention date of appointment).
(ii) My present residential address is……………………. (copy of documentary evidence duly attested by a Gazetted Officer or a whole time practicing professional viz Chartered Accountant/Company Secretary/Cost Accountant) is enclosed (Alternatively, an affidavit sworn before Magistrate may be enclosed).
(iii) My permanent address is…………………………… (copy of documentary evidence duly attested by a Gazetted Officer or a whole time practicing professional viz Chartered Accountant/Company Secretary/Cost Accountant) is enclosed (Alternatively, an affidavit sworn before Magistrate may be enclosed).
(iv) The Company does not maintain any bank account as on date.
(v) The Company ………………… (mention name of the Company) does not have any assets and liabilities as on date.
(vi) The Company has been inoperative from the date of its incorporation/The Company commenced business/operations/commercial activity after incorporation but has been inoperative for the past……………….. year(s) due to following reasons………… (give the reasons here).
(vii) As on date, the Company does not have any dues towards Income Tax/Sales Tax/Central Excise/Banks and Financial Institutions; and other Central or State Government Departments/Authorities or any Local Authorities.
2. I further affirm that –
(i) No inquiry, technical scrutiny, inspection or investigation is ordered or pending against the company;
(ii) No prosecution or any compounding application for any offence under the Act or under any of the other Acts is pending against the company or against the undersigned;
(iii) The company is neither listed nor delisted for non-compliance of listing agreement;
(iv) The company is not a company incorporated for charitable purposes under section 8 of the Companies Act, 2013 or section 25 of the Companies Act, 1956;
(v) The company does not have any management disputes or there is no litigation pending with regard to management or shareholding of the company;
(vi) No order is in operation staying filing of the documents by a court or tribunal or any other competent authority;
(vii) The company is not prevented from making the applications for strike off as mentioned in section 249 of the Act.
The company has fulfilled all pending compliances, if any [Applicable in case an application under sub-section (2) of section 248 has been filed after the initiation of action under sub-section (1) of section 248].
I solemnly state that the contents of this affidavit are true to the best of my knowledge and belief and that it conceals nothing and that no part of it is false.
Signature:_____________________ (Deponent)
Verification:-
I verify that the contents of this affidavit are true to the best of my knowledge and belief.
Place: Signature______________________ (Deponent)
Date:
Note : Attention is also drawn to provisions of section 449 which provide for punishment for false evidence.