FORM NO.

MSC-1 Application to ROC for obtaining the

[Pursuant to sub-section (1) of section 455 status of dormant company
of The Companies Act, 2013 read with rule 3
of The Companies (Miscellaneous) Rules,
2014]

Form Language English ihndI

Refer the instruction kit for filing the form.
1. * Whether the company is incorporated under

Companies Act 2013 Any previous Companies Act

2. (a) *CIN Pre-fill

(b) GLN

3. (a) Name of the company

(b) Registered office

address

(c) email Id

4. Type of company

5. Date of incorporation of the

company

6. Object of the company as per Memorandum of Association (MOA)

7. (a) *Date of passing board resolution (DD/MM/YYYY)

(b) *Date of passing special resolution (DD/MM/YYYY)
(c) *SRN of Form filed for special resolution

8 . (a) *Whether the objects of the company are being regulated under any special Act

Yes No

9. (a) *Number of directors

(b) Particulars in respect of each director

(i) * Director identification number (DIN) Pre-fill

(ii) Name

(iii) *Designation

(iv) *Category

10. *Grounds of application

The Company has not been carrying on any business or operation since (DD/MM/YYYY)

The company has not made any significant accounting transaction during the last two or more financial years.

The company has not filed financial statements and annual returns during the last two or more financial years.

Page # of ##
11. (a) *Whether the company have any assets or liabilities Yes No
Attachments List of attachments
1. *Copy of board resolution authorizing making
Attachment
of this application;
2. *Copy of special resolution; Attachment
3. * Auditor's certificate; Attachment
4. * Statement of affairs duly certified Chartered
Accountant or Auditor(s) of the company; Attachment

6. Consent of the lender if any loan is subsisting; Attachment

8. Certificate regarding no dispute in the management Attachment
or ownership;
9. Optional attachment(s), if any. Attachment

Remove Attachment

Declaration
I* ,
hereby confirm that
i) no inspection, inquiry or investigation has been ordered or taken up or carried out against the company;
ii) no prosecution has been initiated or pending against the company under any law;
iii) the company is neither having any public deposits which are outstanding nor the company is in default in payment
thereof or interest thereon;
iv) the company is not having any outstanding loan or if there is any, the concurrence of the lender has been obtained
and is enclosed herewith this application;
v) there is no dispute in the management or ownership of the company;
vi) the company does not have any outstanding statutory taxes, dues, duties etc. payable to the Central Government
or any State Government or local authorities etc.;
vii) the company has not defaulted in the payment of workmen’s dues;
viii) the securities of the company are not listed on any stock exchange within or outside India;
ix) this application has not been made with an objective to deceive the creditors or to defraud any other person.
x) I am authorized by the Board of Directors of the company vide resolution number *
dated * (DD/MM/YYYY) to sign this form and declare that all the requirements of The
Companies Act, 2013 and the rules made thereunder in respect of the subject matter of this form and matters
incidental thereto have been complied with. I further declare that
a. Whatever is stated in this form and in the attachments thereto is true, correct and complete and no information
material to the subject matter of this form has been suppressed or concealed and is as per the original records
maintained by the company.
b. All the required attachments have been completely and legibly attached to this form all the information given
herein above is true, correct and complete including the attachments to this form and nothing material has been
suppressed.
xi) I understand that furnishing any false or incorrect particulars of any information or Suppression of any
material information shall attract punishment under section 447, 448 and 449.

Page # of ##
 Certificate by practicing professional

I declare that I have been duly engaged for the purpose of certification of this form. It is hereby certified that I have gone
through the provisions of the Companies Act, 2013 and rules thereunder for the subject matter of this form and matters
incidental thereto and I have verified the above particulars (including attachment(s)) from the original/certified records
maintained by the Company/applicant which is subject matter of this form and found them to be true, correct and
complete and no information material to this form has been suppressed.
I further certify that:

i. The said records have been properly prepared, signed by the required officers of the Company and maintained as
per the relevant provisions of the Companies Act, 2013 and were found to be in order;
ii. All the required attachments have been completely and legibly attached to this form.

* Chartered accountant (in whole-time practice) or Cost accountant (in whole-time practice) or
Company secretary (in whole-time practice)

* Whether associate or fellow Associate Fellow

* Membership number

* Certificate of practice number

* To be digitally signed by

* Designation

* DIN of the director; DIN or Income Tax PAN of the manager or

CEO or CFO; or membership number of company secretary

Note: Attention is drawn to provisions of section 448 and 449 of the Companies Act, 2013 which provide for
punishment for false statement and punishment for false evidence respectively.

Modify Check Form Prescrutiny Submit

This eform has been taken on file maintained by the registrar of companies through electronic mode and on the
basis of statement of correctness given by the company.

Page # of ##