FORM-B

PROOF OF CLAIM BY OPERATIONAL CREDITORS EXCEPT WORKMEN AND

EMPLOYEES

(Under Regulation 7 of the Insolvency and Bankruptcy Board of India Fast Track Resolution
Process for Corporate Persons Regulation, 2017)

December 27th, 2018

To,

The Interim Resolution Professional

Mr. XYZ

R/o ______________

From

Uflex Limited

Having its registered office at 305,3rd Floor, Bhanot Corner, Pamposh Enclave, Greater Kailash-
I, New Delhi and corporate office at A-107-108, Sector –IV , Noida, District- Gautam Budh
Nagar, Uttar Pradesh -201301

Subject: Submission of proof of claim.

Madam/Sir,

Uflex Limited, hereby submits this proof of claim in respect of the fast track process in the
case of “GK Dairy and Milk Products Private Limited”. The details for the same are set out
below:

1. NAME OF THE Uflex Limited

 OPEARTIONAL
CREDITOR
2. IDENTIFICATION L74899DL1988PLC032166
NUMBER OF THE
OPRATIONAL
CREDITOR
3. ADDRESS AND E-MAIL Address for correspondence
ADDRESS OF A-107-108, Sector –IV , Noida, District- Gautam Budh Nagar,
OPERATIONAL Uttar Pradesh -201301
CREDITOR OR
CORRESPONDENCE E-mail address

shrishti.jain@uflexltd.com
4. TOTAL AMOUNT OF Total amount of claim
CLAIM, INCLUDING Rs.27,42,118.42/- (Rupees twenty seven lakhs forty two
ANY INTEREST, AS AT thousand one hundred and eighteen only) including cheque
VOLUNTARY bouncing charges amounting to Rs.4,425/-(Rupees four
LIQUIDATION PROCESS thousand four hundred twenty five only).
COMMENCEMENT
DATE AND DETAILS OF
NATURE OF CLAIM
5. DETAILS OF 1. List of 4 purchase orders annexed as ANNEXURE-A.
DOCUMENTS BY 2. Invoices raised by the operational creditor annexed as
REFERNCE TO WHICH ANNEXURE-B.
THE DEBT CAN BE 3. Copy of call records and mails annexed as ANNEXURE-
SUNSTANTIATED C.
4. Copy of cheques and bank return memo dated 26.10.2018
ANNEXURE-D
5. Ledger maintained by the corporate debtor annexed as
ANNEXURE-E
6. DETAILS OF ANY Details of any dispute
 DISPUTE AS WELL AS Institution of a complaint suit under section 138 read with
THE RECORD OF section 142 of the Negotiable Instruments Act, 1881, section
PENDENCY OF SUIT OR 420 of the Indian Penal Code, 1860 and Section 200 of the
ARBITRATION Criminal Procedure Code, 1974.
PROCEEDINGS
7. DETAILS OF HOW AND Details of how and when the debt incurred
WHEN THE DEBT
1. The corporate debtor issued 4 purchase orders dated
INCURRED
28.02.2018, 08.05.2018, 10.05.2018 and 03.09.2018 for the
products namely Laminate fresh Farm mango rush 200ml,
laminate DTM 200ml, Laminate T-star milk 200ml in
Asepto pack, Laminate DTM 1000ml pack and Laminate
Milk Star 200ml in aseptic pack. The quantity and the net
rate has been mentioned in the purchase order.

2. The operational creditor issued invoices to the corporate

debtor regarding the purchase of the products namely
Aseptic Packaging paper GK Asepto brick 200ml slim juice
laminate PPH COATED BOARD, Aseptic Packaging paper
gk gopaljee milk star 200ml Asepto Brick 200 ML Slim milk
Lminate wo opening COATED BOARD along with U5 Ship
156 kg, PP drinking straw (U shape Straw:165MM)(STRAW
Qty per carton-3600 nos) color white, Winding Direction:
B1, Aseptic Packaging paper GK Gopaljee milk star 200 ML
Asepto brick 200ML Slim Milk laminate WO opening
Coaated Board , Aseptic Packaging paper GK Gopaljee Nutri
Milk 1000ML Asepto BRICK LITE SLIM MILK Laminate
WO opening Coated board, Aseptic Packaging paper GK
GopaljeeActive DTM 1000ML Asepto Lite Slim Milk
Laminate WO Opening Coated board. Aseptic Packaging
paper alomg with LS Strip 80 kg GK Gopaljee milk star
200ML Asepto brick 200ML Slim Milk Laminate WO
opening board amounting to Rs.77,91,570.02/-(Rupees
Seventy seven lakhs Ninety one thousand and five hundered
seventy and two paise only). The details of the invoices
raised by client are mentioned below:
INVOICE DATE AMOUNT
NUMBER
1845012500047 21.04.2018 Rs.35,31,980.43/-
1845012500140 31.05.2018 Rs.14,81,150.50/-
1845012500144 31.05.2018 Rs.12,82,777.26/-
1845012500145 31.05.2018 Rs.45,915.10/-
1845012500293 31.05.2018
Rs.14,50,627.34
TOTAL
Rs.77,91,570.02/-

3. The corporate debtor has made the payment of

Rs.50,45,026.73/- and that the total amount due to the
accused is Rs.27,42,118.29/-(Rupees twenty seven
lakhs Forty Two Thousand One Hundred and Eighteen
only) inclusive of Rs.4,425/-(Four thousand four
hundred and twenty five only) for cheque bouncing
charges.
4. The corporate debtor issued 5 cheques for making the
payment of outstanding amounts each drawn by
Oriental Bank of Commerce towards the payment of
outstanding amount which to the shock and surprise of
the operational creditor were dishonored due to reason
of “exceeds aggangements” vide return memo dated
24.10.2018. The details of the cheque issued by the
corporate debtor are as follow :
 Cheque Cheque Returning Amount
no. date date
231374 09.10.2018 Rs.3,00,000
24.10.2018
231427 12.10.2018 24.10.2018 Rs.3,00,000
231376 15.10.2018 24.10.2018 Rs.3,27,065
231421 18.10.2018 Rs.3,00,000
24.10.2018
231422 22.10.2018 24.10.2018 Rs.3,00,000
TOTAL Rs.15,27,065/-
8. DETAILS OF ANY N.A
MUTUAL CREDIT,
MUTUAL DEBTS, OR
OTHER MUTUAL
DEALINGS BETWEEN
THE CORPORATE
DEBTOR AND THE
CREDITOR WHICH MAY
BE SET-OFF AGAINST
THE CLAIM
9. DETAILS OF ANY N.A
RETENTION OF TITLE
ARRANGEMENTS IN
RESPECT OF GOODS OR
PROPERTIES TO WHICH
TE CLAIM REFERS
10. DETAILS OF THE BANK
ACCOUNT TO WHICH
THE AMOUNT OF THE
 CLAIM OR ANY PART
THEREOF CAN BE
TRANSFERRED
PURSUANT TO A
RESOLUTION PLAN
11. LIST OF DOCUMENTS 1. Copy of invoices raised by the operational creditor to
ATTACHED TO THIS the corporate debtor annexed as ANNEXURE-F
PROOF OF CLAIM IN 2. Copy of the Ledger accounts maintained by the
ORDER TO PROVE THE corporate debtor annexed as AVNNEXURE-G
EXISTENCE AND NON- 3. Copy of the bank return memos annexed as
PAYMENT OF CLAIM ANNEXURE-H
DUE TO THE
OPERATIONAL
CREDITOR

Signature of person authorised to act on behalf

of the operational creditor
Name in BLOCK LETTERS
Position with or in relation to the operational
creditor
Address of person signing

AFFIDAVIT

I, ________, currently residing at ______________, do solemnly affirm and state as follows:-

1. GK Dairy and Milk Products Private Limited, the corporate debtor was, at the date
insolvency commencement date , being the ______day of ___ 2018, justly and truly
indebted to me in the sum of Rs.27,44,118.29/- Rupees twenty seven lakhs Forty
Two Thousand One Hundred and Eighteen only) inclusive of Rs.4,425/-(Four
thousand four hundred and twenty five only) for cheque bouncing charges.
 2. In respect of my claim of the said sum or any part thereof, I have relied on the
documents specified below :-
i) Copy of invoices raised by the operational creditor to the corporate debtor.
ii) Copy of the Ledger accounts maintained by the corporate debtor.
iii) Copy of the bank return memos and copy of dishonored cheques
3. The said documents are true, valid and genuine to the best of my knowledge,
information and belief.
4. In respect of the said sum or any part thereof, I have not nor has any person, by my
order, to my knowledge, information and belief for my use , had or received any
manner of satisfaction and security whatsoever.

Solemnly, affirmed at New Delhi on Friday, the 28th day of December 2018.

Oath Commissioner Deponent’s Signature

VERIFICATION

I, the Deponent hereinabove, do hereby verify and affirm that the contents of paragraph 1 to 4 of
the affidavit are true and correct to my knowledge and belief and no material facts have been
concealed therefrom.

Verified at New Delhi on this 28th day of December 2018.

Deponent’s Signature