Mentor Registration Form | Mentorship Program of IIIPI

Mentor Registration

Name

Registration No.

DESIGNATED EMAIL ID (FOR Mentorship Program)*

EMAIL ID (AS Registered WITH IBBI)*

(OTP will send to inbox For verify your email id.)

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Completed Assignments as :

Name of Assignment*

In the Capacity CIRP/ Liquidation*

Initiation Date*

Completion Date by the order of AA*

Industry/Sector of the CD under IBC*

Whether Operational during the CIRP/ Liquidation*

Asset Size (Rs. in Lakhs)*

Claim Size (Rs. in Lakhs)*

#	Name of assignment	In the Capacity CIRP/ Liquidation*	Initiation Date	Completion Date by the order of AA	Industry/Sector of the CD under IBC	Whether Operational during the CIRP/ Liquidation	Asset Size (Rs. in Lakhs)	Claim Size (Rs. in Lakhs)	Action

Current AFA Date

Whether any suspension/adverse order has been passed by the Disciplinary committee of IBBI/IIIPI?

Yes

Disclaimer : Members are specifically informed that the views expressed by the mentors would be their personal views and not necessarily the views of the IIIPI.

Confidentiality : I undertake to ensure the confidentiality of the information received from/exchanged with mentees, at all times in future. I also confirm that I do not have any conflict of interest directly /indirectly in the assignment.

I agree