CERTIFICATE A. (Counterfoil to be retained by theselling dealer) FORM ST.XXII-A[See rule 29(xi)] Issued to M/s _________R.C. No. ____________ dated _______________ on _________________for goods valued atRs. ________________ Under Rupees No. U N D E RRU PEES B. (To be retained by the purchaser FORM ST. XXII-A[See rule 29(xi)]____________________________ R.C. No. _________ Dated ______ I/We ___________ have sold the goods detailed overleaf forRs. _________________________ (Rs. ____________________ only) to M/s ______________________R.C. No. _________ dated _______ I/We ___________________ am/are *in the State of Punjab and shall be liable to tax under the Punjab General Sales Tax Act, 1948 and shall pay tax on the above sale. OR *The goods have suffered tax at the hands of M/s ____________ R.C. No.______ dated _______ from whom I purchased them, ______ vide sale/delivery order No. _______ dated ________ for Rs. ______ (Rs. _____ only)No. ____________ U N D E RRU PEE S C. (To be furnished by the purchas ing dealer to the Assessing Authority with the return) FORM ST.XXII-A [See rule 29(xi)] __________________________ R.C.No.______ Dated_______ I/We _________ have sold the goods detailed overleaf for Rs.___ (Rs. __________________ only) to M/s ____________________ R.C. No. _________dated_____ I/We ________________ am/are *in the State of Punjab and shall be liable to tax under the Punjab General Sales Tax Act, 1948 and shall pay tax on the above sale. OR *The goods have suffered tax at the hands of M/s __________ R.C. No. _______ dated _____from whom I purchased them,______ vide sale/delivery order No. ________ dated ________ for Rs. _____ (Rs. _____ only) No. ___________ Signature of the selling dealer Signature of the selling dealer *Please tick which is applicable *Please tick which is applicable (Contd.) (Form ST.XXII-A contd.) REVERSE Sale/Delivery Order No. and date Description of goods Quantity Price Sale/Delivery Order No. and date Description of goods Quantity Price 1 2 3 4 1 2 3 4 Total Total
