CA_Statement_Exclusive

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TO WHOMSOEVER IT MAY CONCERN This is to certify that (Name of Father) and (Name of Mother), presently residing at (Address) , sponsors of their son (Your Name) for higher studies in USA, have the following assets in their name as on 1st June 2001 : Description Movable Assets Immovable Assets Indian Rs. Rs. 40, 61, 235 Rs. 37, 90, 000 US $ (@ 1 US $ = Rs. 47 ) $ 86, 409 $ 80, 638 Total Rs. 70, 51, 235 $ 145, 045 Total Rupees (In words) Total US Dollars (In words) We have verified the relevant documents to verify the validity of these figures and found them to be true and correct. Place : Ahmedabad Date : 1st June, 2001 (Name of the Company). Chartered Accountants (Name of Propreitor) Proprietor, M No 34975 MOVABLE ASSETS (Annexure A) 1. Bank Balance (Part 1) 2. Fixed Deposits & other liquidable assets (Part 2) 3. Provident Fund & PPF (Part 3) 4. Jewellery (Part 4) 5. Equity Shares (Part 5) Rupees US$ (@1US$ to 47 Rs.) $ 30, 777 $ 15, 201 $ 16, 597 $ 9, 698 $ 14, 136 ---------------$ 86, 409 US$ (@1US$ to 47 Rs.) $ 20, 319 $ 60, 319 ---------------$ 80, 638 $ 145, 045 12, 46, 522 8, 14, 474 6, 45, 046 3, 55, 790 7, 64, 403 ---------------Rs. 40, 61, 235 Rupees IMMOVABLE ASSETS (Annexure B) 1. Residential Flat at Ahmedabad 2. Ancestral Land at 24 Parganas, near Kolkata 12,55,000 28,35,000 ---------------Rs. 37,90,000 Rs. 70, 51, 235 TOTAL Annexure A : Movable Assets Part 1 : Bank Balance Details : 1 Savings in the name of X and / or Y (SB Account : 53992, Bank Name, since Sept 27, 1999) 2 Savings in the name of Z (SB 46438, Bank Name since Jan 23, 1991) Rs. 8, 50, 136 Rs. 4, 36, 522 Total Rs. 12, 46, 522 Annexure A : Movable Assets Part 2 : FDRs with Bank & Other Assets a) Fixed Deposits with Banks Sr. No 1 2 3 INDIAN Bank. INDIAN BANK. Canara Bank Type Amount Maturity Value (Rs.) (Rs.) 1, 00, 000 1, 08, 780 75, 000 81, 585 1, 00, 000 1, 08, 775 5, 85, 108 7, 33, 937 Total b) Security Bonds Sr. No. Type Number of Units 500 2 500 500 Face Value (Rs.) 10 5000 10 10 Value (Rs.) 5, 000 10, 000 5, 000 5, 000 Name of Mother 1 CANPEP 1992 2 ICICI Tax Saving Bonds Name of Father 3 UTI MEP 1992 4 CANPEP 1992 Total 60, 000 Annexure A : Movable Assets Part 2 (contd.) c) Policies Sr. No. Type Amount Invested (Rs.) 30, 000 30, 000 47, 505 Name of Mother 1 ULIP Name of Father 2 ULIP 3 Jeevan Suraksha Pension Policy Yourself 4 LIC Policy 13, 032 Total Rs. 3, 20, 537 Total Invested Value ( a + b + c ) Total Maturity Value : : Rs. 7, 14, 474 Rs. 7, 65, 645 Annexure A : Movable Assets Part 3 : Provident Fund Balance of Parent (Through X years of service in W as on 31.3.2001) Details: 1 Staff Provident Fund 2 Public Provident Fund (PPF) Rs. 6, 87, 505 Rs. 92, 541 Total Rs. 7, 80, 046 Annexure A : Movable Assets Part 4 : Jewellery (As per Valuation Report of X, Government Approved Registered Valuer (if done)) Details : 1 Diamond Jewellery 2 Gold Jewellery Rs. 1, 76, 710 Rs. 2, 79, 080 Total Rs. 4, 55, 790 Annexure A : Movable Assets Part 5 : Equity Shares in Companies (As on June 1, 2001) Sr. No. Type Number of Shares Repurchase Price Per Share (Rs.) 29.05 151.75 52.10 59.60 193.50 283.85 Value (Rs.) Name of Mother 1 Henkel Spic 2 HFCL 3 Reliance Petro 4 Thermax 5 HLL Name of Father 6 Moses Bayer Eq. 100 700 500 100 100 100 2, 905 1, 06, 225 26, 050 5, 960 19, 350 28, 385 Total Rs. 6, 64, 403 GRAND TOTAL ( Part 1 + 2 + 3 + 4 + 5 ) : Rs. 40, 61, 235 Annexure B : Immovable Assets Details : 1 Flat Address 2 Flat Address Rs. 12, 55, 000 Rs. 28, 35, 000 Total Rs. 37, 90, 000 We have verified the validity of the above assets and value thereof by vouching necessary documents and found them to be true and correct. The information given above is true and correct to the best of my knowledge and is based on the information given to us. Place : Ahmedabad Date : 1st June, 2001 (Name of the Company). Chartered Accountants (Name of the Propreitor). Proprietor, M No 34975

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