Department of Goods Tax Government of Arunachal Pradesh Form FU-03 (See Rule 51 of the Arunachal Pradesh Goods Tax Rules, 2005) Form of Recovery Certificate Office of the Goods Tax Officer, ., Arunachal Pradesh Date Recovery Certificate Number: <<Number>>/<<Date>>/<<Year>> To The Collector, ________________, Arunachal Pradesh This is certified that a sum of Rs. _________________ is due from M/s (TIN No.: ) on account of arrears in Goods tax, penalty and interest as per details provided below: S.No. Particulars of arrears Tax period Amount The dealer has registered office at _______________________ and the lists of additional places of business are provided below: 1. 2. 3. The particulars of persons who stood as surety for the dealer are as provided below: 1. Name of surety 2. Registration Number 3. Address of business premises 4. Mailing address 5. Amount of surety With reference to the provisions of section 45 of the Arunachal Pradesh Goods Tax Act, 2005 and the Rule 51 of the Arunachal Pradesh Goods Tax Rules, 2005 you are hereby requested to recover the said sum as if it was an arrear of land revenue. The amount recovered may please be credited in the appropriate Government Treasury in the Consolidated Fund of Arunachal Pradesh (provide appropriate details). The particulars of the person or persons liable to pay the amount under this certificate are given below: Name of the proprietor/partner/ Director, etc. Father's name Residential address Details of properties owned Signature Designation Place Date
