MSME DECLARATION CUM AGREEMENT

I____________________________________________________________________________________________________________Proprietor/ Partner/ Director of

M/s _________________________________________________________ d o her eb y d e cl are tha t a b ove
concern is REGISTERED / NOT REGISTERED under MSMED Act, 2006.
Our Details are as under:
Name of the Concern
PAN No.
If Yes Udyam Registration No.
Date of Udyam Registration
Type of Enterprise Micro / Small / Medium
Type of Activity Manufacturer / Trader / Service Provider
Turnover for F.Y, 2022-23 (Tick whichever is applicable)
0-10 Cr
> 10-50 Cr
-

 More Than 50Cr

)
Investment in Plant & Machinery till 31.03.2023 (Tick whichever is applicable)
➢ 0-1 Cr
➢ 1-10 Cr
➢ More Than 10 Cr
*Please cut off non relevant items.
Note:
1. If registered under MSMED Act, 2006 then provide copy of Udyam Registration.
2. If registered under MSMED Act, 2006 then the credit terms between buyer & seller would be 45 days
(maximum) from date of acceptance of goods or services.

Declaration
1. I/ We hereby declare that the above details given are true and correct. In case any detail is found incorrect then
I/we are only responsible for the consequences under the respective act.

2. If the above declaration is not given within 15 days from date of receipt, then it will be presumed that the above
concern is not registered under the MSMED Act, 2006.

3. I/We do hereby declare that our concern does not fall under the category of Micro, small & medium enterprises
as defined by MSMED Act,2006 and declare that the credit terms defined under Sec. 15 of MSMED Act, 2006
are not applicable to us. (If not registered under MSMED Act, 2006).

Date:
Place: Authorized Signatory
(with Seal & Signature)