Seal of Issuing Office Form VAT-39 [See Rule 39(5) & 44] Receipt for cash deposit of Tax/ Amount in lieu of Tax (To be issued by the Contractor) Receipt No. ........ Date: ORIGINAL for depositor DUPLICATE to be submitted to the Department TRIPLICATE to be retained by the contractor Name of Contractor ........................................................................................................... Address: .............................................................................................................................. .............................................................................................................................. Name of specified Area/ Check Post: ............................................................................ Commodities on which authorised to collect tax .................................................. ............ Notification No.: Date: Period of Contract from ....................................... to.............................................. Name of Tax collection Centre ............................................................................. Name of Casual Trader/ Registered dealer/ Purchaser....................................................... ....................................... Description of Goods ................................................................................ Weight/Quantity/Value of the goods.................................................................................... Type of vehicle (Truck/Trolla/Tractor trolly/others).............................................................. Registration No. of Vehicle.................................................................................................. Rate of Tax ............... /Per Ton/Per Item/ @ Percent (%) Amount of Tax /Composition Money/ Exemption Fee Rs. (In Figures) ................................(In words) .................................................................... .............................................................................................................................................. Signature of Contractor or Authorised representative
