Sample Section 9 Application – Form 5

 Form 5  

(See sub-rule (1) of Rule 6)

Application by Operational Creditor(s) to initiate Corporate Insolvency Resolution Process

Part I – Particulars of Applicant  

1. Name of the Operational Creditor: [Your Name / Firm Name]  

2. Identification Number (PAN/Aadhaar):  

3. Address:  

4. Email & Phone:  

Part II – Particulars of the Corporate Debtor  

1. Name of the Corporate Debtor:  

2. CIN:  

3. Registered Office Address:  

Part III – Details of Operational Debt  

1. Total amount of debt: ₹ [amount]  

2. Date from which debt became due:  

3. Date of default:  

4. Particulars of invoices: [list invoice numbers, dates, amounts]  

5. Supporting documents attached:  

   - Invoices  

   - Delivery proofs  

   - Bank statements  

   - Demand notice and proof of service  

Part IV – Proposed IRP (if any)  

[You may propose a Resolution Professional here – optional]

Part V – Declaration  

That the applicant has not received any payment and that no notice of dispute has been received.

**Signature**  

[Name & Signature of Applicant or Authorized Representative]  

[Date and Place]

**Annexures**:  

- Copy of demand notice (Form 3) and delivery proof  

- Invoices  

- Affidavit under Section 9(3)(b)  

- Certificate from financial institution (if applicable)  

- Authorization (if filed by legal counsel)