Declaration of solvency in Form SH-9, with affidavit

To be filed with the Registrar of Companies before the buy-back — not to be filed with SEBI by an unlisted company

DECLARATION OF SOLVENCY
[Form SH-9 — pursuant to Section 68(6) of the Companies Act, 2013 and Rule 17(3) of the Companies (Share Capital and Debentures) Rules, 2014]

1. Corporate Identity Number: [Company's CIN]
2. Name of the company: [ABC Private Limited]
3. Address of the registered office: [Company's registered office address]
4. E-mail address: [Company's e-mail address]
5. Date of the [Board resolution / special resolution] authorising the buy-back: [Date of the authorising resolution]
6. Number and class of securities proposed to be bought back: [Equity shares to be bought back (number)] equity shares of Rs [Face value of each equity share (Rs)] each
7. Buy-back price per security and aggregate consideration: Rs [Buy-back price per equity share (Rs)] per equity share · Rs [Total buy-back amount (Rs)] in aggregate
8. Date of the Board meeting at which the declaration was adopted: [Date of the Board meeting adopting the declaration]

DECLARATION