FORM NO. 13.
THE COJMPANIES ACT, 1956
 
Register of charges

[persuant to section 130, 135, 137 & 138]
Registration No. 						Nominal Capital 

Particulars of charge(s) 	created by a company registered in India	
	Subject to which property has been acquired by company registered in India 	

       Name of the Company ………………………. Limited/Private Ltd. Presented by……………	
	created	
       Particulars of charges(s)	subject to which property has been acquired	
………………………………… Limited/Private Limited a company registered in India.	

PARTICULARS OF CHARGE UNDER SECTION 125

1.		Date and description of the instrument the creating the charge. 		
2.		Amount secured by the charge/amount owing on security of the charge 		
3.		Short particulars of the property charged. If the property acquired is subject to charge, date of the acquisition of property should be given .		
4.		Gist of the terms and conditions and extent and operation of the charge.		
5.		Names and addresses and description of the person entitled to the charge.		
			
PARTICULARS REGARDING CREATION OF CHARGE IN CASE OF SHRIES OF DEBENTURES UNDER SECTION 128/129.		
			
6.		Date and amount of each series of debentures --- 
Date               Amount               Total                 		
7.		Date and amount of the present issue of series.		
8.		Date of  resolution authorising the issue of series.		
9.		Date of the covering deed (if any), by which the security is created of defined; or if there is no such deed, the first execution of any debenture of the series.		
10.		Names and addresses of the trustee (if any) for the debenture holder.		
11.		Date of registration of the series.		
12.		Particulars as to the amount or rate per cent of the commission, allowances or discount (if any) paid, or made either directly or indirectly by the company to any person in consideration of subscribing or agreeing to subscribe, whether absolutely of conditionally or procuring or agreeing to procure subscription, whether absolute or conditional, for any of the debentures included in this return. 		
	
PARTICULARS OF MODIFICATION OF CHARGE UNDER SECTION 135.
	
13.		Date and brief description of instrument modifying the charge		
14.		Particulars of modifications already registered/filed in the office of the Registrar of  Companies.		
15.		Particulars of modification specification specifying the terms, conditions or the extent of operation of the charge in which modification is made, and the details of the modification.		
16.		APPOINTMENT OF RECEIVER UNDER SECTION 137.		
	a)	Name, address and date of appointment of receiver.		
	b)	Date on which the receiver ceased to act.		
17.		MEMORANDUM OF COMPLETE SATISFACTION OF CHARGE UNDER SECTION 138.		
	a)	Date of creation of original charge and amount secured.		
	b)	Date of registration/date of filling of the particulars with the Registrar of Companies:		
	c)	Date of filing of the memorandum of satisfaction/Date of entry of satisfaction.		

Signature

Name
(in Block Capitals) 

Designation
Dated this 		 day of		 19.

(FOR OFFICE OF REGISTAR OF COMPANIES ONLY)
18.	Date of Registration. 
19.	Serial No. of the document in file.
Signature of Registrar of the Companies