FORM NO.56CA  
[See clause (c) of sub-rule (4) of rule 2D] 
Statement of assets and liabilities   
                                                                                                                          YEARS 
                                                               FirstYear        SecondYear  ThirdYear 
 
 (Mention years also )   
  
A.  ASSETS 

1.  Fixed assets  
                 (a) Gross block  Rs.....……...............  ..………...................  ...........………......... 
                 (b) Depreciation  Rs.................……...  .....………...............  .....………............... 
                 (c) Net value (a-b)  Rs..........……..........  ....………................  .............………....... 
2.  Current assets        
                  (a) Investments   Rs...........….…........  .............……….......  ...............………..... 
                (b) Cash and bank balances   Rs......……..............  .........………...........  .......………............. 
               (c) Others (please specify)   Rs.........……...........  ..........………..........  .........………........... 
                  (d) Total [(a) + (b) + (c)]   Rs.....…...................  .....………...............  ...………................. 
3.  Current liabilities and provisions  Rs..........…..............  ..………..................  .................………... 
4.  Net worth (1 + 2 - 3)  Rs............……........  .....………...............  .………................... 
      
B.  Liabilities 
 Rs…........................  ..………..................  ........………............ 
1.   Monies raised /issued and paid-up 
capital 
 Rs..……..................  ..........………..........  ......……….............. 
2.  Free reserves (excluding revaluation  
reserves) 
3.  Total (1 + 2) 
 Rs...................…….  ........………............  .............………....... 

 
 
Place .......…………....... 
 
........................................................................ 
Date  …..........……......... 
              Signature and designation of the applicant