Form No. DIR-5
Application for surrender of Director Identification Number
[Pursuant to section 153 of the Companies Act, 2013 and rule 11 of the Companies (Appointment and Qualification of Directors) Rules, 2014]
Refer instruction kit for filing the form
All fields marked in * are mandatory
Photograph of the DIN holder
(Attach a latest passport size photograph by clicking on above box)
(Note: DIN mentioned aforesaid will be replaced with all the other DINs for which surrender application is filed by the user)
(c) Name of the DIN holder
(d) Father’s Name
3 *Specify the number of DIN(s) being surrendered by the applicant
Particulars of the DIN(s) being surrendered
(i) S. No.
(ii) DIN
(iii) Name
(iv) Father’s Name
5 Particulars of the applicant
6 Other information, if any, which the applicant intends to submit with regard to this application
*To be digitally signed by
*Name
*DIN/PAN
Certificate by Practicing Professional
Note: In case where the applicant is residing outside India the particulars have to be verified from the documents duly attested by the attesting authority as prescribed.
*Whether associate or fellow
*Membership number
Certificate of practice number
Note: Attention is drawn to provisions of Section 448 and 449 which provide for punishment for false statement / certificate and punishment for false evidence respectively.
For Office Use Only:
eform Service Request Number(SRN)
eform filing date (DD/MM/YYYY)
Digital signature of the authorizing officer
This eForm is hereby approved
This eForm is hereby rejected
Date of signing (DD/MM/YYYY)
Your request for Form DIR-5 has been submitted against SRN {srn}.
Please navigate to application history for downloading the PDF.
The filing status will be confirmed only after successful DSC verification and payment confirmation. The additional (delay) fee, as applicable, will be levied till the date, payment is confirmed, and acknowledgment is generated
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You have successfully submitted the form. Your Service Request Number is {srn}
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