Form-21

CLAIM STATEMENT TO BE FILED BEFORE THE ARBITRATOR IN CASE WHERE THE VEHICLE
IS CONFISCATED

BEFORE THE SOLE ARBITRATOR SHRI ________________________

CLAIM PETITION NO. OF______________________

In the matter of Arbitration and

Conciliation Act, 1996

And

In the matter of disputes and

differences between M/s.Hinduja Leyland Finance
Ltd and Mr. _________ and
Another.

M/s. Hinduja Leyland Finance Ltd,

No.1, Sardar Patel Road,
Guindy,
Chennai 600032
and its Corporate Office at
No.27A, Developed Industrial Estate,
Guindy,
Chennai 600 032 and
Represented by its Power of Attorney,
Shri. ___________ Claimant
Vs
01 ..
..
..
.. Respondent No.1

02. .
..
..
.. Respondent No.2

The claimant above named humbly submits as follows:

1. The Claimant is a financing company incorporated under the Companies Act, 1956, and having its
registered office at No.1, Sardar Patel Road, Guindy, Chennai 600032 and its Corporate Office at No.27A,
Developed Industrial Estate, Guindy, Chennai 600 032 and is represented herein by its authorized representative
Shri. ________________ who is the Power of Attorney Holder and who is conversant with the facts and
circumstances of the case.
 The address for service of all notices and processes on the Claimant is the same as stated above.

2. The First respondent is _________________ S/o. ___________/ aged about ____ years/ (age and
fathers name is not known to the claimant) and having office/ residence at _____________________________
The Second respondent is _______________S/o. __________ / aged about ___ years,/(age and fathers
name is not known to the claimant) and having office / residence at______________________.
The address for service of all notices and processes on the 1 st and 2nd respondents are the same as stated
above.

3. The Claimant is a financing company incorporated under the Companies Act, 1956, and having its
registered office at No.1, Sardar Patel Road, Guindy, Chennai 600032 and its Corporate Office at No.27A,
Developed Industrial Estate, Guindy, Chennai 600 032 and having branches all over India. The core business of the
Company among others is providing loan facility to the customers for the purchase of motor vehicles, automobiles
and machinery's etc., During the course of the business, the First respondent approached the Claimants branch
Office at ______ in the month of______________20_ and requested for grant of loan for the purchase/refinance a
Vehicle, more fully described in the schedule hereunder (hereinafter referred as the Vehicle)"

4. I state that the 1st respondent as a borrower and the 2 nd respondent as a guarantor have entered in to a
loan agreement with the Applicant for the purchase/refinance of the schedule mentioned vehicle under agreement
no. _______, dated wherein a sum of Rs. ______________ /- was advanced to the First respondent by the
Applicant/Plaintiff herein as vehicle finance loan for the said vehicle to the respondents.

5. It is submitted that the 2nd respondent, the Guarantor in the said Agreement, has assured and guaranteed the
prompt payment of loan amount and due fulfillment of the obligations by the first Respondent as per the
terms and conditions of Loan Agreement. The 2nd Respondent undertook to indemnify the Claimant in case
of any/all the defaults/breach of any terms and conditions committed by the 1st respondent/borrower and
also undertook to make payment when the Lender invokes his guarantee on the happening of any/all of the
events of default.

6. It is submitted that as per the Loan Agreement, the Respondents are due and liable to repay the loan
amount i.e. Rs.________ towards the finance of the Vehicle and finance charges of Rs.__________/- and
insurance deposit of Rs.. totaling to a sum of Rs.___________ /- in . equated monthly
installments commencing from. The instalment amounts are payable at Rs.__________ /- for the
first instalment and Rs. ________ from 2 nd installment to ..instalment and Rsfrom
.instalment no. to .. installment no.. . The monthly instalment falls due on ..day of every month
and the last instalment falls due on
 The 1st respondent had also issued post dated cheques for the repayment of the said EMIs. In the event of the
cheques not honoured/ payment not effected by the 1 st respondent/Borrower as per clauses__ and ___ of the
Agreement, the 1st respondent/Borrower shall be liable to pay the additional financial charges, at the rate of 36% on
all the outstanding amount till the date of receipt of the same.

7. The first respondent had paid only ______ monthly installments and that too quite irregularly. Several
cheques issued by the first respondent were dishonoured and thus the respondents have committed breach
of Agreement. The claimant herein had made repeated personal visits and oral and telephonic follow
ups/reminders demanding the installment amounts payable as per the schedule and till date the respondents
had not bothered to pay the outstanding amount due.

8. The claimant further states that solely based on the said loan Agreement entered by first Respondent and
on the guarantee given by second Respondent, the Claimant had disbursed the amount to the First
Respondent as vehicle finance loan for the schedule mentioned vehicle subject to all the terms and
conditions set out in the Loan Agreement.

9. It is submitted that the vehicle was hypothecated and offered as security to the claimant by the respondents.
In the event of default committed by the 1 st respondent / Borrower in the payment of monthly
installments/charges etc., the claimant is entitled to take possession of the schedule mentioned asset as per
the Agreement.

10. As per the terms and conditions of the agreement the schedule mentioned asset should be kept in the
custody and possession of Respondents and it should not be removed to any other place other than the place
mentioned in the Loan Agreement without the prior written consent of the Claimant. In this regard the
Claimant herein states that contrary to the terms and conditions contained in the said Loan Agreement, the
first respondent is not able to produce the vehicle for inspection and the same is not traceable by the
Claimant. In spite of repeated requests by the Claimant to produce the vehicle the Respondents herein has
not produced the vehicle and has not disclosed the whereabouts of the vehicle. Further, The Claimant came
to understand that the subject vehicle was seized by the ______________Authorities for the involvement
of the vehicle for the illegal transportation of ___________ goods. As per terms and conditions of the Loan
agreement (Clause__) the First Respondent is prohibited from using the vehicle for any illegal or unlawful
purposes. And hence the Claimant herein suspects that the deliberate intention of the Respondents is to use
the vehicle for illegal and unlawful purposes thereby making it liable to be confiscated by the
..Authorities. The Respondents have committed criminal breach of trust and cheating
punishable under Indian Penal Code.

11. It has been stipulated in the said Loan Agreement that if the respondents defaulted in paying the loan
monies or suffered any of the acts prohibited, in violation of the terms and conditions of the agreement, the
claimant has the right to take possession of the schedule mentioned vehicle and sue for all the installments
 due and for damages for breach of the agreement with all costs and expenses. But the Claimant could not
take the vehicle back to its custody on account of the same being seized /liable to be confiscated for its
involvement in illegal activities by the first respondent.

12. It is submitted that the 1 st respondent deliberately failed to adhere with the payment schedule as per
the Agreement and had paid a meagre sum so far and that too quite irregularly. Further, several cheques issued
by the 1st respondent were returned dishonoured which could be revealed from the Statement of Accounts filed
herewith. Despite claimants repeated demands for the due amount, the respondent has not bothered to pay the
outstanding amount due and has been constantly committing defaults thereby attracting Additional finance
charges @___ % as per the terms and conditions of the said Loan Agreement for the defaulted
installments/delayed payments.

13. In spite of several requests, follows ups and reminders by the officials of
Claimant, the Respondent no.1 has been evading payment of loan installments and Additional Finance charges due
to the claimant. The claimant herein has totally lost their confidence in the Respondent herein. The Respondent No.1
has utilised the schedule vehicle with out making any payment of loan installments and has committed several
defaults.

14. The Claimant states that no duty is cast on the Claimant to chase the schedule
mentioned vehicle and the Respondents are liable to surrender the asset at Claimants place where the contract was
entered into in terms of the loan Agreement and pay the entire dues to the Claimant.

15. The Claimant further states that the Respondents (as participants in the capacity of Borrower and
Guarantor) are not only liable to pay the loan due but also are liable to pay damages to the Claimant for
violating the terms and conditions of the Loan Agreement. The claimant reserve their right to file
additional Claim Petition or to amend this Claim Petition for claiming damages from the Respondents
herein.

16. The claimant states that in terms of the Loan Agreement, if the Respondent fails to pay the Loan
installment amounts on the due dates and/or commits default in payment of the above Loan installment
amount the Claimant is inter alia absolutely entitled to get return of the vehicle. As the vehicle is seized by
the .. Authorities the Claimant is not in a position to act on their own to take possession of the
vehicle.

17. The total dues payable by both the respondents under the loan Agreement as on---- is as follows :

A. towards Overdue Rs. ______________

B. towards Future due Rs. ______________
C. additional Finance charges Rs. ______________
D. other costs Rs. ______________
 E. Total Rs. --------------------

18. The claimant further submits that as per the terms and conditions of the Loan Agreement, if the respondents
fail to pay any of the Loan installments with in the stipulated time (whether demanded or not) they suffer
an act of breach. Further in terms of clause 15.7.2 of the said Loan Agreement, the Borrower/1 st respondent
is bound to return to the claimant the schedule vehicle along with Registration Certificates, Insurance
policies, permits if any relating to the vehicle.

20. It is submitted that, in respect of the recovery of the said total due sum, as per clause no.__, a dispute exists
between the claimant and the respondents and the same is referable to the Arbitration in accordance with clause
no.__ of the Agreement. As such, this Honble Tribunal has got ample jurisdiction to entertain the above
referred matter and to adjudicate the same. In this regard, the Claimant had terminated the Loan Agreement by
its letter dated _________, wherein the respondents were duly informed about the initiation of Arbitration
Proceedings and the respondents were also called upon to settle the dues amicably, but in vain. Therefore, the
respondents are jointly and severally liable to pay a sum of Rs. ______/- to the Claimant towards the Loan
installments and additional finance charges.

21. The claimant further reserves the right to alter, amend or file additional grounds at any time during the
pendency of the dispute before the Arbitrator and also reserve their right to claim damages at a later date.

21. The Cause of action for the arbitration to resolve the dispute arose at Chennai, which is the place of
arbitration as agreed between the parties herein, as per Clause no.__ of the Loan Agreement. Further, this claim
is filed with in the time limit.

22. In the above circumstances and without prejudice to what is stated hereinabove, the claimant prays for the
following reliefs and the Learned Arbitrator may be pleased to pass an award granting the same :
a. directing the respondent No.1 & 2 to jointly and severally pay a sum of Rs.______________
(Rupees____________________________ only).
b. Directing the Respondents to jointly and severally pay the claimant interest @ __% per annum for the
above amount from________ until date of realization.
c. In the event of respondents failing to make the above payments within stipulated time, directing the
respondents to offer security for Rs.. to the satisfaction of the Claimant
d. directing the First Respondent to get back the confiscated vehicle from the ..Authorities by
furnishing suitable security.
e. Directing the respondents to pay the cost of arbitration.
f. Such other relief as the learned arbitrator may deem fit in the facts and circumstances of the case.

Dated at _______ on this the ____ day of ______________/20

 CLAIMANT

SCHEDULE

VEHICLE __________________(Model)
REGN NO. __________________
CHASSIS NO. ____________
ENGINE NO._______________

CLAIMANT
VERIFICATION
I , the authorized representative of the Claimant herein hereby verify and state that the contents
in para 1 to _____ above are true to the best of my knowledge and belief and I believe them to be true.

CLAIMANT

LIST OF DOCUMENTS FILED

1. Invoice
2. Loan Agreement
3. Certificate of Registration
4. Statement of Accounts
5. Additional Finance Charges statement
6. Cheque bouncing details
7. Letters issued to the party demanding payment
8. Letters received from the party

CLAIMANT