1[Form 5A

[Under section 9(3)(c) of the Code]

(To be issued on the letter head of the Bank / Financial Institution)

To whomsoever it may concern

Based on a request of ……….(name and address of person), having an account(s) bearing No…… at …. branch of bank/financial institution, it is certified that the following amounts have been credited in the last three years to this account on behalf of corporate debtor (name and address of the corporate debtor from whom the amount is supposed to be credited).

Date of credit

Amount of credit (Rs.)










                                                                                                                                                                                                                                                                 (Signature and Name of issuing authority)


Date :


Place :    ]




1. Inserted by Notification no. G.S.R. 583(E) :The Insolvency and Bankruptcy (Application to Adjudicating Authority) (Amendment) Rules, 2020. dated. 24th September, 2020