FORM No.

55
Registration No. of Company F......................................................................
THE COMPANIES ACT, 1956
Particulars of charge' on property in India created by a foreign company after the
15th January, 1937
[Pursuant to section 600 read with section 1251
Name of Company....................................................
Presented by..............................................................
Particulars of mortgage or charge created by........................................a company incorporated in
and which has established a principal place of business in India at.............................................................
...................................................................................................................................................................

Date and Amount Short Gist of the Names, Amount or rate percent
description secured by particulars of terms and adresses of the commission,
of the the charge the charged conditions descriptions of allowances or discount
instrument and extent the. persons (if any) paid or made
creating or and operation entitled to the either directly or
evidencing of the charge charge indirectly by the
the charge company to any person
in consideration of his
subscribing, or
agreeing to sub-
scribe,whether
absolutely or
conditionally, or
procuring or agreeing
to procure sub-
scriptions,whether
absolute or
conditional, for any of
the debentures
included in this return

1 2 3 4 5 6

Signature or signatures of one or more persons.............................................................

authorised under section 592@l)(d) of the....................................................................
Companies Act, 1956 or of some other person..............................................................
in India, duly authorised by the company......................................................................
Dated the .............................day of .... .......... 19.......................
1 "Charge" includes "mortgage". [See section 1241
2 Country of origin.
3 A description of the instrument e.g. "Trust Deed", "Mortgage", "Debentures", etc. as the case may
be should be given.
4 Persons entitled to the charge will include mortgagees.
5 The rate of interest payable under the terms of the debentures should not be entered.