FORM  NO. RSC - 5

[See Rule 3(5) ]

Before the National Company Law Tribunal Bench at _____

Affidavit on dispatch and publication of notice

I............................... (name, etc.), do solemnly affirm and say as follows :--

1.       I did on the ............... day of ............... 20...... despatched a copy of the notice now produced and shown to me and marked 'B' upon each of the respective persons whose names, addresses and descriptions appear in the list of creditors filed on the............... day of ............... 20...... by sending such copies by registered or Speed post to their respective addresses appearing in the said list, and the postal receipts and the acknowledgments [including (if any) the covers returned as undelivered] now produced and shown to me and marked 'C' to 'Cn' are the receipts and acknowledgments received from the post office in respect of the said registered letters.

2. A true copy of the notice marked 'D' has been published in the issue(s) of............... (state the newspapers) dated the ............... 20.....

Solemnly affirmed

(Sd.).............……