Form 25
THE COMPANIES ACT, 2017
THE COMPANIES (GENERAL PROVISIONS AND FORMS) REGULATIONS, 2018
[Section 131(6) and Regulation 4]
STATUTORY REPORT
PART-I
(Please complete in typescript or in bold block capitals.)
1.1 CUIN (Registration Number) 0 2 1 9 4 5 4
1.2 Name of the Company The United Life Assurance Company Limited
1.3 Fee Payment Details 1.3.1 Challan No 1.3.2 Amount
PART-II
2.1 Nominal share capital of the company No of shares 100 Million
Rs. per share 10
Amount 1 Billion
2.2 Statutory report duly certified pursuant to section 131
dd mm yyyy
2.2.1 Date of Report 0 7 0 9 2 0 2 3
2.2.2 Date of notice calling statutory 0 8 0 9 2 0 2 3
meeting
2.2.3 Date on which the meeting is to be 3 0 0 9 2 0 2 3
held
2.2.4 Place where meeting is to be held Karachi
2.3 The Statutory report to the members is as follows:
dd mm yyyy
2.3.1 Shares allotted and cash received up 0 7 0 9 2 0 2 3
to
(the date should be within 15 days of the date of report)
2.4 Particulars Kind / No of Nominal Cash
Class of shares value of received
shares each share
2.4.1 Allotted subject to Ordinary 70 10 700
payment thereof in cash. Million Million
2.4.2 Allotted as fully paid up
otherwise than in cash
N/A N/A N/A N/A
and the consideration for
which the shares have
been so allotted being: (to
be specified)
2.4.3 Allotted at a discount per share of Rs. N/A
2.5 Abstract of receipts and payments of the company upto the aforesaid date:
(Attach a copy of Auditor report)
Receipt Rs Payments Rs
Share Capital 700,000,000/- Preliminary expenses 7,575,545/-
Commission on issue or
sale of shares / redeemable
Capital / debentures.
Loans – Preliminary 7,575,545/-
expenses incurred by Discount on issue or sale of
Holding company shares / redeemable Capital
/ debentures.
Capital expenditure:
Land………………….
Building………………
Plant………………………
Machinery…………….
Other Items (to be
specified)
Balances……………..
In hand……………….
At Banks…………… 700,000,000/-
Total: 707,575,545/- Total: 707,575,545/-
2.6 Preliminary expenses as estimated in the Prospectus/Statement in lieu of Prospectus (Rs.): N/A
Preliminary expenses actually incurred up to the aforesaid date:-
(a) Legal & professional Charges Rs. 2,812,500
(b) Incorporation Fee Rs. 4,413,045
(c) Stamp and Registration fees N/A
(d) Advertisement N/A
(e) Commission on issue or sale of shares / redeemable N/A
capital/debentures.
(f) Discount on issue or sale of shares / redeemable N/A
capital/debentures.
(g) Other initial expenses (to be specified). Rs. 350,000
Total:- Rs. 7,575,545
2.7 Name, Father’s Name, NIC No(s), addresses and occupations of the Directors, Chief
Executive, Secretary, Auditors and Legal Advisers of the Company and the changes, if any,
which have occurred since the date of the incorporation;
Name Fathers NIC No. Addresses Occupation Particula
/Husband’s rs of
Name Changes
, if any
2.7.1 Directors
1 Agha Ali Imam Agha Jafar 3520225801565 House No. Consultant
Hussain 67, C-1,
Gulberg-III,
Lahore.
2 Jamil A. Khan Haji Abdul 6110122526111 Bungalow Business
Majeed No. 74/1 8
Khan street,
Khayaban-
e-badar,
Phase-VII,
DHA,
Karachi.
3 Muhammad Malik 3630227111935 House No. Consultant
Asghar Muhammad 57-6, Shafi
Sharshah
road,
Multan.
4 Muhammad Muhammad 3520256818843 424 Street # Service
Rahat Sadiq Sadiq 2, R Block (Insurance)
Phase 7
Cantonment
Lahore
Punjab
Pakistan
54000.
5 Mian Chaudhry 3520014354605 Mian House Business
Muhammad Muhammad 70-E, Model (Insurance)
Akram Shahid Rasheed Town,
Lahore.
6 Huma Waheed Abdul 4210195628280 A-134, Professional
Waheed Block-C,
Khan (Late) Gulshan-e-
Jamal,
karachi.
7 Syed Rahat Ali Syed 3540385874615 House No. Corporate
Shah Munawar 208, Block- Consultant
Ali Shah C, OPF
Housing
Scheme,
Khayaban-
e-Jinnah
Road,
Lahore.
2.7.2 Chief Executive
1 Muhammad Muhammad 3520256818843 424 Street # Service
Rahat Sadiq Sadiq 2, R Block (Insurance)
Phase 7
Cantonment
Lahore
Punjab
Pakistan
54000.
2.7.3 Secretary
1 Athar Ali Khan Jafar Ali 4220105864481 R-28, Safari Service
Khan Sunlay
Cottages
Scheme 33,
Sector 35,
Karachi.
2.7.4 Auditors
1 RSM Avais Plot No. 18- Chartered
Hyder Liaquat B-1, 1st Accountants
Noman Floor
Chohan
Plaza, G-8
Markaz,
Islamabad.
2.7.5 Chief Accountant/CFO
1 Naeem Tariq Muhammad 3520287018231 House No. Service
Afsar Khan 111,
Waheed
Brothers
Colony,
19KM,
Ferozpur
Road,
Lahore.
2.8 Particulars of any contract the modification of N/A
which is to be submitted to the meeting for its
approval together with the particulars of the
modification or proposed modification.
The particulars must include dates of changes.
2.9 The extent to which underwriting contract if N/A
any, has been carried out, if contract not carried
out fully, extent to which it has not been carried
out and reasons therefor.
2.10 The particulars of any commission or brokerage N/A
paid or to be paid in connection with the issue
or sale of shares to any director, chief executive,
secretary or officer or to a private company of
which he is director
2.11 Brief account of the Company’s affairs since its Company has filed a formal application for
incorporation and the business plan, including registration as a Life Insurance Company
any change affecting the interest of under Section 6 of the Insurance Ordinance,
shareholders and business prospects of the 2000 and under rule no. 6 ,7 and 8 of the
Insurance Rules, 2017 with SECP. Further,
company.
Business Plan is attached.
2.12 We hereby certify this Report* as correct and that nothing has been concealed or withheld
in this regard.
2.13 Signature N/A
2.14 Name of Signatories Muhammad Rahat Syed Rahat Ali N/A
Sadiq Shah
2.15 Designation Chief Executive Director Chief Financial
Officer Officer (only in case
of listed company)
PART-III
3.1 Declaration:
I do hereby solemnly, and sincerely declare that the information provided in the form is:
(i) true and correct to the best of my knowledge, in consonance with the record as
maintained by the Company and nothing has been concealed; and
(ii) hereby reported after complying with and fulfilling all requirements under the relevant
provisions of law, rules, regulations, directives, circulars and notifications whichever
is applicable.
3.2 Name of Authorized Officer with Rahat Sadiq CEO
designation/ Authorized Intermediary
3.3 Signature
3.4 Registration No of Authorized Intermediary, if applicable N/A
Day Month Year
3.5 Date 0 7 0 9 2 0 2 3
