FORM NO. 16

Registration No. of the Company . Nominal
Capital: Rs.

THE COMPANIES ACT, 1956

Notice to be given by receiver/manager on ceasing to

act as such

[pursuant to section 137(2)]

Name of the company Limited
/Private Limited.
Presented by

To
The Registrar of Companies
I of Hereby give you notice that I ceased
to act as receiver/manager of the Limited on the

day of 19

Signature
Receiver/Manager

Dated this Day of 19