claimreconciliationpcl.apaaris.com
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URL:
http://claimreconciliationpcl.apaaris.com/
Submission: On March 06 via manual from IN — Scanned from DE
Submission: On March 06 via manual from IN — Scanned from DE
Form analysis
1 forms found in the DOM<form _ngcontent-bps-c7="" novalidate="" class="form ng-untouched ng-pristine ng-invalid">
<div _ngcontent-bps-c7="" class="form-group mt-2"><label _ngcontent-bps-c7="">Email ID *</label><input _ngcontent-bps-c7="" type="email" formcontrolname="emailId" required="" class="form-control ng-untouched ng-pristine ng-invalid"><!----><!---->
</div>
<div _ngcontent-bps-c7="" class="form-group mt-2"><label _ngcontent-bps-c7="">Identification Proof Number *</label><input _ngcontent-bps-c7="" type="text" formcontrolname="identificationNo" required=""
class="form-control ng-untouched ng-pristine ng-invalid"><!----><!----></div>
<div _ngcontent-bps-c7="" class="form-group mt-2 w-100"><label _ngcontent-bps-c7="" for="captcha">Enter CAPTCHA</label>
<div _ngcontent-bps-c7="" class="input-group row">
<div _ngcontent-bps-c7="" class="col-md-10"><input _ngcontent-bps-c7="" type="text" id="captcha" formcontrolname="captcha" name="captcha" required="" class="form-control captchinput w-50 float-start ng-untouched ng-pristine ng-invalid">
<div _ngcontent-bps-c7="" class="input-group-append mx-0 my-2 w-50 float-start px-2"><span _ngcontent-bps-c7="" class="captcha-text float-start" style="pointer-events: none; user-select: none;">4PwPST</span><button _ngcontent-bps-c7=""
class="btn btn-outline-secondary mx-2"><i _ngcontent-bps-c7="" class="fa-solid fa-arrows-rotate"></i></button></div>
</div>
</div><span _ngcontent-bps-c7="" class="text-danger ng-star-inserted"> Please enter valid captcha </span><!---->
</div><!---->
</form>
Text Content
PANCARD CLUBS LIMITED (Cuurently under Corporate Insolvency Resolution Process) ENTER CLAIMANT DETAILS AS SUBMITTED UPON CLAIM SUBMISSION Email ID * Identification Proof Number * Enter CAPTCHA 4PwPST Please enter valid captcha In view of rectification / modification of the claim through the Folio Reconciliation Portal, I/We make the following declaration: Login DECLARATION English/हिंदी IN VIEW OF RECTIFICATION / MODIFICATION OF THE CLAIMS THROUGH THE FOLIO RECONCILIATION TOOL, WE MAKE THE FOLLOWING DECLARATION: 1. This declaration is in respect of modification/rectification of my claim or any part thereof made by me through the Folio reconciliation tool. 2. The changes/modifications made by me in the claim form through the Folio reconciliation tool, are true, valid and genuine to the best of my knowledge, information and belief and no material facts have been concealed therefrom. 3. Any change made in the folio reconciliation portal should be read as supplemental to the Claim Form / upload on resolute portal submitted by me and revision made in the folio reconciliation portal will supersede the respective submission made in the claim form / upload on resolute portal. 4. I hereby declare that there is no change in the remaining part(s) of the claim form / / upload on resolute portal. I undertake the responsibility to declare, disclose and provide immediately, within the permissible time limits, any changes that may take place in the information provided herein/or otherwise, as well as in the documentary evidence provided by me or if any certification becomes incorrect or undergoes a change. 5. I hereby declare that I understand the contents of this declaration provided at the time of making modification/rectification of my claim through the Folio Reconciliation Tool. 6. In case the above information is found to be false or untrue or misleading or misrepresenting, I am aware that I will be held liable for it and appropriate legal action will be taken against me.