Kotwani's Value Added Tax 1"FORM VAT - 16A [See Rule 53(7) & 54(7)] Application for obtaining declaration forms VAT-47 & VAT-49 To, .......................................................... .......................................................... 1. Name of Dealer 2. Registration No. (TIN) 3. Address Bldg. No/Name/Area Town/City District (State) Pin Code Telephone Number(s) 4. Name of Declaration form required 5. No. of books required containing 25 declaration forms each 6. Details of Challan / receipt in support of deposit of Amount requisite fee. 7. Date of filing of last due return DD / MM / YYYY (enclose copy of acknowledgement) Declaration I/We declare that my / our Registration Certificate mentioned above is in force and has not been cancelled by this date. I/We further declare that (a) I/We have properly used the declaration forms issued to me/us in the past (List be enclosed) (b) I/We have no demand outstanding to be payable by me/us; (c) I/We have submitted my/our all due returns along with necessary enclosures; (d) I/We have deposited the due tax till date; and (e) I/We have furnished necessary security as demanded by the assessing authority. 1. Inserted by clause 4(i) of the Rajasthan Value Added Tax (Fourth Amendment) Rules, 2008. 312 The Rajasthan Value Added Tax Forms I/We authorise Shri ________________________________________ my/our authorised representative, whose signature is attested below, to receive the said forms on my/our behalf. Place : Signature : Date : Name : Status: Verification I verify that the information given in this form and its attachments (if any) is true and correct to the best of my knowledge and belief and nothing has been concealed. Place : Signature : Date : Name : Status : Instructions: 1. Please read the instructions carefully. 2. All the entries should be filled in capital letters. 3. Tick 9applicable in option boxes. 4. Enclose proof of payment of requisite fees. 5. This Form should be verified and signed by: a. Proprietor, in case of Proprietorship concern. b. Managing Partner, in case of Partnership firm and where there is no Managing Partner, by any other Partner. c. Managing Director or authorized signatory, in case of a Company. d. Karta, in case of Hindu Undivided Family. e. Authorised Signatory, in all other cases. f. Or by the declared Business Manager." 313
