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Application
Form For Issue Of Declarations In Form ST - 1/ST - 35/C/F/
Forms
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| (1)
Name and style of the business |
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(2)
Full Address :
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| (3)
Local R.C. No. :/Autharisation No. |
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| (4)
No. of un-utilised forms in hand : |
| (5)
No. of forms now required : |
| (6)
Return period quarterly/monthly : |
| (7)
The period/year upto which the assessment has
been last made : |
| (8)
Whether all returns due till date since the last
assessment have been furnished and the tax due
according to them paid ? If not, state the
defaults and reasons thereof : |
| (9)
Whether any amount of arrears of tax still
remains payable? If so, state the year and the
amount of arrears and reasons for non-payment. |
| I do
hereby solemnly affirm and declare that the
above information is true and correct to the
best of my knowledge and belief. |
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Signature
of the Dealer _______________ |
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Status
_______________ |
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Please
deliver __________________ forms of Shri
__________________ an employee of my firm. His
signatures are attested below : |
| Signature
of Shri __________________ |
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| Signature
Attested |
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| Signature
____________________ |
Signature
of Dealer ____________________ |
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(1)Signature
of the applicant tally/do not tally with these
on record. |
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(2)Verified
that the dealer has filed all returns
up-to-date. If not, mention defaults. |
| (3)
Arrears due,, if any: |
Year |
Amount |
Local
or Central |
Remarks |
| (4) If
there is any other material or information
which, according to law, could withholding of
forms or issue of lesser number, give
particulars. |
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Signature
of the concerned Official(s) __________________ |
| Order of
Assessing Authority |
Signature
of assessing authority |
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