Reference to the Micro and Small Enterprises Facilitation Council under section 18

BEFORE THE MICRO AND SMALL ENTERPRISES FACILITATION COUNCIL, [State of the Facilitation Council], AT [Place of the Facilitation Council]

Reference No. [Reference number] of [Year of the reference] (Samadhaan case number [Samadhaan case number])

(Filed under section 18 of the Micro, Small and Medium Enterprises Development Act 2006)

In the matter of

[Name of the supplier], a [proprietorship concern of Shri [name] / partnership firm / private limited company] having its principal place of business at [Supplier's full address of principal place of business], registered as a [micro / small] enterprise under the Micro, Small and Medium Enterprises Development Act 2006 with Udyam Registration Number [Supplier's Udyam Registration Number] dated [Date of the supplier's Udyam registration], holding Permanent Account Number [PAN] and goods and services tax registration [Supplier's GSTIN], through its [Proprietor / Partner / Director] Shri [Name of the person acting for the supplier] … Supplier / Applicant