FORM I [see rule 7(1)(a), 7(2) & 7(3)] VALUE ADDED TAX MONTHLY RETURN Name of the dealer: To The Assessing Authority,........ Circle, TIN Month INPUT TAX CREDIT TAX PAYABLE Year A. Payment details: : Amount payable,if (T4) is excess of (E) (T4 - E) (Rs.) Amount paid (Rs.) Sl.no Amount (Rs.) Crossed cheque /Crossed DD / Crossed Banker's cheque No. Date Bank Bank code Total: (in words)Rupees B. Amount of Input Tax Credit excess available,if (E) is excess of (T4) (E - T4) (Rs.) LESS: 1.If refund is claimed for input tax related to Zero rate sales,the amount 2.If tax payable under the CST Act for this month has to be adjusted, the amount: Total (1+2) Input Tax Credit,if any,carried forward to next month: (Rs.) DECLARATION 1. I/We.......... declare that to the best of my/our knowledge and belief the information furnished in the above statement is true,correct and complete. 2. I/We.......declare that I am/We are authorised by.......Proprietor/Partner/Board of Directors to sign the returns. Place: Signature Name: Date: Seal Status & relationship to the dealer: ANNEXURE I Details of purchases/receipts during the month ....... Sl.No. Name of the seller Seller's TIN Commodity Code Purchase/Receipt value(Rs.) Rate of tax VAT/CST paid (Rs.) Category (1) (2) (3) (4) (5) (6) (7) (8) Category: C-Capital goods, E-Exempted, I-Import ,O-Inter-State purchases, R- Local-purchase input(First schedule), S-Stock receipts from Head office/branches/ principals outside the state, A-Purchases effected through agents/Branches, B-Industrial Input ANNEXURE II Details of sales/transfer value during the month ....... Sl.No. Name of the buyer Buyer's TIN Commodity Code Sale value(Rs.) Rate of tax VAT/CST paid (Rs.) Category (1) (2) (3) (4) (5) (6) (7) (8) Category: E-Exempt, F-First schedule , R-Sales return ,S-Stock transfer outside the State, Z-Zero rate sale,A -Sales effected through agents/branches in the State ANNEXURE III Details for reversal of Input Tax Credit during the month ........... Sl.No. Nature of transactions Section/Rule relevant Commodity Code Value(Rs.) Rate of tax TIN Reversal of Input tax Credit (Rs.) (1) (2) (3) (4) (5) 1 Goods used for civil structures Sec.2(11) 2 Goods utilised for self use Sec.19(7)(a) 3 Purchase of automobiles and spare parts other than dealer in Automobiles Sec.19(7)(b) 4 Purchase of Airconditioners other than dealer in Airconditioners Sec.19(7)(c) 5 Goods given as gift,free sample Sec.19(8) 6 Goods lost on theft,loss etc., Sec.19(9((i) 7 Inputs destroyed in fire or lost Sec.19(9)(ii) 8 Inputs damaged in transit or destroyed before manufacture Sec.19(9)(iii) 9 Unavailed credit on Capital goods (time barred) Sec. 19(3)(b) 10 Consignment Sales without 'F' form Sec. 19(4)(i) & (ii) 11 Stock transfer without 'F' form Sec. 19(4)(i) & (ii) 12 Purchases for production of Exempted goods (Finished) Sec 19(5)(a) 13 Interstate sale without 'C' form Sec. 19(5)( c ) 14 Purchase return Sec. 14(i) 15 ITC availed for Finished goods subsequently exempt Sec. 19(12) 16 Others (specify) Total ANNEXURE IVImport Export code: Zero Rated sale S.No INPUT TAX PAID Seller's TIN Description of goods Commodity code Purchase value (Rs.) Rate of tax Input tax paid (Rs.) Eligible Credit (Rs.) (1) (2) (3) (4) (5) (6) (7) (8) S.No EXPORT Description of Goods Commodity Code Value (Rs.) Details of Bill of lading / Air / Road / Railway Bill No. & date (1) (2) (3) (4) (5) Note:-Details of Input Tax Paid need not be filled ,if furnished in Annexure I,unless there is change in eligible credit Place: Signature: Name: Date: Seal: Status & relationship to the dealer:
