FORM-1: MEDIATION APPLICATION FORM

DISTRICT LEGAL SERVICE AUTHORITY, CIVIL COURT SAMASTIPUR

DETAILS OF PARTIES:

1. Name of the applicant: Mr. Ram Singh

2. Address and contact detail of the applicant:

Address :- Punjabi colony, Samatipur

Telephone No.____________ Mobile:____________ E-mail ID_____________

3. Name of Opposite party: Mr. Pawan Singh

4. Address and contact details of opposite party:

Address: Marwari bazaar, Samastipur

Telephone No._____________ Mobile________________E-mail ID______________

DETAILS OF DISPUTE:

1. Nature of Dispute as per section 2(1)(c) of the Commercial Courts Act 2015(4 of 2016): U/S 2
© (xviii) agreement for sale of goods and provisions for services. Section 2© (xxi) Agency
contract for sale of goods

2. Quantum of claim: Rs. 1,25,54,905

One crore, twenty-five lakh, fifty-four thousand, nine hundred and five rupees with interest
@18%

3. Territorial jurisdiction of the competent court: Commercial court, Samastipur

4. Brief synopsis of commercial dispute: (5000 words)

1. The dispute is recovery of the designated amount stated below vide demand notice dt. 22-
02-2019 duly served making a demand of Rs. 1,25,54,905/- as business dues pursuant to your
breach of agreement dated 01-04-2018 by stoppage of supply since November 2018 and
rendition of fabricated account of dues vide your communication dated15-02-2019.

2. We have already intimated through our lawyer’s notice dated 09-02-2019 our intention to
reconcile and settlement of accounting being debit and credit between us and continue with the
business in usual course but telephonic talks from your side leads to conclude that you are
interested to scrap our business relation in order to hush up our huge demand and dues
recoverable from you.

3. Beside that against our huge claim for guarantee replacement, due commission and other
recoverable dues, you have arbitrarily shown meager amount as credit entry and have attempted
to project in your communication that out of three blank cheques namely cheque no.
077535,077536,077537 handed over to you in 2014 for liquidation of any demand arising before
the channel system of payment between us was adopted, one cheque no. 077536 is shown to
have been fraudently used to show instrument of payment of Rs 68,45,000/- in your
communication dt. 15-02-2019 and has been submitted to the bank for clearance.

4. To put the record straight, out of three cheques, cheque no. 077535 was used on 03-05-
2014 for Rs. 200,000/- and cheque no. 077357 was used on same day for Rs. 400,00/-. Your
office reported about cancellation and destruction cheque no. 077536 as such another cheque of
Rs. 1,44,690/- dt. 24-07-2014 was given to the company for payment fan bill. Thus as per your
intimation no unused cheque remained with the company. All the cheques were issued on PNB.

5. You have been illegally unilaterally recovering interest through chaneel finance account
from time to time without any liability or agreement on alleged ground of delayed payment.
Therefore, we are entitled to refund of Rs. 335364/- being recovered amount of interest. At the
same time charging of interest at Rs. 4,54,462/ + 88544-20/+2822 to raise demand of Rs.
6722196-16 in your communication is only to show fictitious dues to cover the fraudulent and
forgery of issuing old cheque which was falsely intimated by you to have been destroyed in
2014. Therefore we are entitled to recover from you a sum of Rs. 335364/- . Being illegal
amount of interest recovered from us since 201 besides the amount stated in Annexure 1.

6. As per agreement specific area of operation was allotted to us for selling your goods
through dealers appointed by us. However during, the operational period, you have appointed
your own separate dealer/agent for at least four marketing areas. This is clearly breach of
agreement. Reducing operational area has substantially reduced our turnover resulting into loss
of annual sale of more than 1.5 crore @twelve lakh per month. The action of reduction and
curtailment of the above marketing area is clear breach of agreement and undertaking by you.
Therefore, you are liable to compensate for business loss of expected profit and commission at
the rate of 4% of total lose of annual turnover of about 1.5 crore which comes to Rs. 600,000/-.
This demand is raised as recoverable from you in addition to the amount of Annexure 1.
7. That we are enclosing herewith statement of dues payable by you under normal dealing
of business as Annexure 1 which has been prepared on the basis of account maintained by us.
The amount has been arrived at after adjusting the amount payable by us against supply made to
us up to October 2018. The statement contained in Annexure 1 is self explanatory.

8. The company has breached the agreement by stopping supply of goods form Nov 2018.
Expected monthly loss commission is Rs. 200,000/ per month. The company therefore is liable
to compensate for the loss at Rs. 10,00,000/ for five month loss.

9. Thus to summarize our total demand recoverable from you are indicated as under.

(A) Amount recoverable as per Annexure 1- Rs. 105,89,581-50

(B) Rental for godown of replaceable guarantee goods Rs. 30,000/-

(C) Recoverable interest illegally realized since 2014—Rs. 335364/-

(D) Compensation for business for reduced area---- Rs.600,000/-

(E) Business loss due to stoppage of supply --- Rs1000,000/

Total-------------------------------------------------Rs. 1,25,54,905

(One crore twenty five lakhs fifty four thousand nine hundred and five only)

10. We expect that good sense will prevail over the authorities of Surya Roshni Ltd and
instead of indulging in litigation either a civil side or criminal side we appreciate our approach
and settle each and every issue by sitting across the table at Samastipur in company office or at
our office. We assure that on proper accounting, if any amount is payable by us shall pay
-forthwith and also expected that if any amount is found payable to us the same shall be paid by
you forthwith. This proposal for amicable settlement is without prejudice to our right to initiate
legal action for recovery of the said amount through process of court.

11. That this demand notice should be treated as final demand for payment of the due amount
of Rs 1,25,54,905/-

12. As detailed above. Time for such action is given up to 05-03-2019 falling which we shall
adopt proceeding for recovery of the commercial amount stated above through process of the
court at Samastipur court being in force. No further notice shall be given if our demand for the
specified sum stated above is not paid by 05-03-2019 or our dues is otherwise satisfied by that
date.
13. you are therefore required, requested and called upon to make payment of the amount
determined to be due as above by 05-03-2019 at Rs 1,25,54,905/- in full and final satisfaction of
each and every claim arising from the agreement dt. 01-04-2018 and business dealing conducted
there under.

5. Additional points of relevance. May be submitted in hearing.

Details of fee paid Rs. 1000/ vide

Fee paid by DDNo._______________ dated_____________ name of the branch of the bank

__________ (payment if demanded shall be made during the proceeding)

Date:____________ Name and signature of the applicant

 FORM-2: Notice/ Final Notice to the Opposite party for Pre- Institution Mediation

[See Rule 3(2) and Rule 3(3)]

Name of the Authority and address

1. Whereas a commercial dispute has been submitted to (name of Authority) by (name of

applicant) against (name of opposition party) requesting for pre-institution mediation in
terms of section 12A of Chapter IIIA of commercial Courts Act, 2015. A copy of the
mediation application Form is attached herewith.

2. The opposite party is hereby directed to appear in person or through his duly authorized
representative or Counsel on _________________ (Date)_______________(Time) at
the (Authority address) and convey his consent to participate in mediation process.

3. Failure to appear before the Authority by opposite party would be deemed as his refusal
t o participate in mediation process initiated by the applicant.

4. In case, the date and time mentioned in para 2 is sought to be rescheduled the same can
be done by the opposite party either on its own or through its authorized representative
or counsel by making a request in writing at-least two days prior to the scheduled date of
appearance.

Date: Signature of the Authority

 FORM 3: Non-Starter Report

[See Rule 3(4) and (6)]

Name of the Authority and address

1. Name of the applicant:

2. Date of application for Pre-Institution mediation:

3. Name of the opposite party:

4. Date scheduled for appearance of opposite party:

5. Report made under rule 3(4) or 3(6):

6. Non Starter Report reason: ________________________________________________

_______________________________________________________________________
_______________________________________________________________________
_

Date: Signature of the Authority

Copy to:

Applicant.

Opposite Party.
 Form 4: Settlement

[See Rule 7(1)(vii)]

Name of the Authority and address

1. Name of the Mediator:

2. Name of the applicant:

3. Name of the opposite party:

4. Date of application for Pre-Institution mediation:

5. venue of mediation:

6. Date(s) of mediation:

7. No. of sittings and duration of sittings:

8. Terms of settlement:

Date:

Signature of Applicant Signature of opposition party

Signature of Mediator
 Form 5: Failure Report

[See Rule 7(1)(ix)]

Name of the Authority and address

1. Name of the Mediator:

2. Name of the applicant:

3. Name of the opposite party:

4. Date of application for Pre-Institution mediation:

5. venue of mediation:

6. Date(s) of mediation:

7. No. of sittings and duration of sittings:

8. Reason for failure:

Date:

Signature of Applicant Signature of opposition party

Signature of Mediator