BEFORE THE MICRO AND SMALL ENTERPRISES FACILITATION COUNCIL, [STATE / DISTRICT]

REFERENCE NO. [____] OF 20__

[Supplier name], Udyam No. [____] ... Applicant (Supplier)

versus

[Buyer name and address] ... Respondent (Buyer)

REFERENCE UNDER SECTION 18(1) OF THE MSMED ACT, 2006

1. Parties. The Applicant is a [micro / small] enterprise located at [address], within the jurisdiction of this Council. The Respondent is the buyer of goods/services supplied by the Applicant.

2. Supply. Under PO/Contract [____] dated [____], the Applicant supplied [description] and raised invoices totalling ₹ [____], listed in Schedule 1.

3. Acceptance and due date. [State delivery dates, absence of written objection or the date any objection was removed, the agreed payment term if any, and the resulting section 15 due date.]

4. Amount due. Principal ₹ [____]. Interest under section 16 up to [date] ₹ [____], computed in Schedule 2. Total ₹ [____], with further interest until payment.

5. Attempts at recovery. [Notice dated __ and reply, if any.]

6. Registration. The Applicant’s Udyam registration dates from [date]. [State whether the supplies fall before or after registration.]

7. Prayer. The Applicant prays that the Council (a) conduct conciliation under section 18(2); (b) if conciliation fails, take up arbitration under section 18(3), or refer the dispute to an institution or centre; (c) award the principal and interest under section 16 until payment, with costs; and (d) pass any other order the Council thinks fit.

Place: [__]  Date: [__]        [Authorised signatory, Applicant]

Documents: Schedule 1 (invoices, challans, acknowledgements); Schedule 2 (interest statement); Udyam certificate; PO/Contract; notice and proof of service.