Name of the Printer/ Self Computer Printed (in Bold letters) (Counterfoil Not transferable) Serial no. (To be filled in by the permitholder before Transport of Goods) 1. Name of dealer by whom the permit is issued with TIN Number. 2. Name and address of the consignor ......... 3. Name and address of the consignee ......... 4. Place of dispatch .................... 5. Destination ...................... 6. Name of notified railway station/other place, from where delivery is to be taken ..... 7. Number and date of a. Railway receipt ............ b. Other document ............ 8. Description of consignment Name of goods value quantity 9. Seller's invoice/forwarding note number and date .... 10. Mode of transport (vehicle no.) ............ I/We hereby declare that the above statements are correct and complete to the best of my/our knowledge and belief. Signature of dealer/declared manager Date ........ RESULT OF CHECKING ON THE ROUTE Designation Description of Quantity of the Dated and head goods goods actually signature of quarters of the transported. the authority authority by mentioned in whom column I and transport of place of consignment checking was checked. 1 2 3 4 NOTE(1) Separate form should be used for each consignment. (2) (a) In case of transport across or beyond checkpost, a copy of the form should accompany the consignment. (b) In case of delivery of consignment from any notified railway station/other such place the original copy of the form shall accompany the consignment in transit and thereafter shall be sent to the appropriate authority of the Commercial Taxes. GOVERNMENT OF JHARKHAND COMMERCIAL TAXES DEPARTMENT FORM JVAT 504 G Form of Permit [See Rule 42(2)(b)] Name of the Printer/ Self Computer Printed (in Bold letters) (Duplicate Not transferable) Serial no. (To be filled in by the permitholder before Transport of Goods) 1. Name of dealer by whom the permit is issued with TIN Number. 2. Name and address of the consignor ......... 3. Name and address of the consignee ......... 4. Place of dispatch .................... 5. Destination ...................... 6. Name of notified railway station/other place, from where delivery is to be taken ..... 7. Number and date of a. Railway receipt ............ b. Other document ............ 8. Description of consignment Name of goods value quantity 9. Seller's invoice/forwarding note number and date .... 10. Mode of transport (vehicle no.) ............ I/We hereby declare that the above statements are correct and complete to the best of my/our knowledge and belief. Signature of dealer/declared manager Date ........ RESULT OF CHECKING ON THE ROUTE Designation Description of Quantity of the Dated and head goods goods actually signature of quarters of the transported. the authority authority by mentioned in whom column I and transport of place of consignment checking was checked. 1 2 3 4 NOTE(1) Separate form should be used for each consignment. (2) (a) In case of transport across or beyond checkpost, a copy of the form should accompany the consignment. (b) In case of delivery of consignment from any notified railway station/other such place the original copy of the form shall accompany the consignment in transit and thereafter shall be sent to the appropriate authority of the Commercial Taxes. Name of the Printer/ Self Computer Printed (in Bold letters) (Original Not transferable) Serial no. (To be filled in by the permitholder before Transport of Goods) 1. Name of dealer by whom the permit is issued with TIN Number. 2. Name and address of the consignor ......... 3. Name and address of the consignee ......... 4. Place of dispatch .................... 5. Destination ...................... 6. Name of notified railway station/other place, from where delivery is to be taken ..... 7. Number and date of a. Railway receipt ............ b. Other document ............ 8. Description of consignment Name of goods value quantity 9. Seller's invoice/forwarding note number and date .... 10. Mode of transport (vehicle no.) ............ I/We hereby declare that the above statements are correct and complete to the best of my/our knowledge and belief. Signature of dealer/declared manager Date ........ RESULT OF CHECKING ON THE ROUTE Designation Description of Quantity of the Dated and head goods goods actually signature of quarters of the transported. the authority authority by mentioned in whom column I and transport of place of consignment checking was checked. 1 2 3 4 NOTE(1) Separate form should be used for each consignment. (2) (a) In case of transport across or beyond checkpost, a copy of the form should accompany the consignment. (b) In case of delivery of consignment from any notified railway station/other such place the original copy of the form shall accompany the consignment in transit and thereafter shall be sent to the appropriate authority of the Commercial Taxes.
