Capital Structure Certificate
Date: ___________
To Whomsoever It May Concern,
This is to certify that on the basis of examination of the books of account, statutory registers (including Register of Members), records and documents of M/s __________________________ (the “Company”), CIN: __________, having its Registered Office at ______________________, and according to the information and explanations provided by the management, the Capital Structure of the Company as on ** (date)** is as under:
A. AUTHORIZED SHARE CAPITAL
| Class of Shares | No. of Shares | Face Value (INR) | Amount (INR) |
| Equity Shares | __________ | __________ | __________ |
| Preference Shares (if any) | __________ | __________ | __________ |
| Total Authorized Capital | __________ |
B. ISSUED, SUBSCRIBED & PAID-UP SHARE CAPITAL
| Class of Shares | No. of Shares | Face Value (INR) | Amount (INR) | Paid-up Value (INR) |
| Equity Shares | __________ | __________ | __________ | __________ |
| Preference Shares (if any) | __________ | __________ | __________ | __________ |
| Total | __________ | __________ |
C. BREAK-UP OF PAID-UP SHARE CAPITAL
| Sr. No. | Name of Shareholder | No. of Shares Held | Face Value (INR) | Amount (INR) | % of Holding |
| 1 | __________________ | __________ | __________ | __________ | __________ |
| 2 | __________________ | __________ | __________ | __________ | __________ |
| … | … | … | … | … | … |
| Total | __________ | __________ | 100% |
D. OTHER DETAILS (IF APPLICABLE)
- Calls in Arrears: __________
- Forfeited Shares: __________
- Share Warrants (if any): __________
- Convertible Instruments (CCPS/CCD, etc.): __________
- ESOP/ESPS Outstanding: __________
Notes:
- The above particulars have been compiled based on the books of account, records, and documents produced before me/us and maintained by the Company.
- I/We have relied upon the information and explanations provided by the management and have not carried out an independent legal verification of title/ownership of shares.
- This certificate is issued at the specific request of the Company for the purpose of __________________ and should not be used for any other purpose without my/our prior written consent.
Place: ___________
For __________________________
(Chartered Accountants)
(Firm Registration No.: __________)
Signature: ____________________
Name of Partner/Proprietor: ____________________
Membership No.: __________
UDIN: _______________________
