Form A-IV Application for grant of Tax Clearance Certificate under section 42 of the Bihar Value Added Tax Act, 2005 (See rule 30) Office of the .................................................................................. of Commercial Taxes ...................................................................................Circle To, The ........................................................................... .................................................................................................................... circle. I ................................................................................................... (full name), son of ...................................................................................................... (full name) hereby apply for the grant of clearance certificate under section 42 of the Bihar Value Added Sale Tax Act, 2005 and furnish the following particular for that purpose - 1. Name and style of Firm ........................................................................................................................................................................................ ........................................................................................................................................................................................ ........................................................................................................................................................................................ 2. Taxpayer Identification No. ........................................................................................................................................................................................ 3. Whether the applicant has any arrears of tax, interest or penalty in Yes relation to which no stay order contemplated under clause (a) of No sub-rule (2) of rule 30 has been passed? 4. Period in respect of which returns required by section ......................................................................................................... 24 have been furnished 5. If the applicant is not registered under the Bihar Value Added Tax Act, 2005, has the undertaking specified under the second proviso to section 42 been attached? ......................................................................................................................................................................................................................................................................................... ......................................................................................................................................................................................................................................................................................... ......................................................................................................................................................................................................................................................................................... (Give details) DECLARATION I do hereby declare that the particulars furnished in this application are correct and complete to the best of my knowledge and belief. Place ................................................... Signature of the Applicant .......................................................... Date ................................................... Status in relation to the dealer ..............................................................................................................
