FORM XXVII TRIPURA VALUE ADDED TAX ACT, 2004 ( Under Rule 55(1) of TVAT Rules ) (Application form for issue of permit for exporting taxable goods from Tripura) To The Superintendent of Taxes Sl. Number of Form....... ____________ Charge In accordance with the provisions of Section 66 of the Tripura Value Added Tax Act read with Rule 54(1) of Tripura Value Added Tax Rules, 2005, I/We* hereby declare that the consignment detailed below is required to be exported from Tripura, by Rail/Air/Steamer and apply for a permit to transport the same by road/by boat from the railway station/steamer station/Post Office/Air Port mentioned below :- (1) Name, address and TIN under TVAT/Registration No. under CST : ......... Act of the Applicant (in-case the applicant is not registered, details of registered dealer from whom goods have been purchased) (2) Name and address of the consignee (Registration No. in : ............................. case consignee is a registered dealer under CST Act) (3) Place of Despatch : ............................. (4) Name of railway station/ steamer station/ post office/ : ............................. airport from where goods will be sent (5) Destination : ............................. (6) Description of consignments Sl. No. Item Code Description Quantity & Unit Weight (Kgs) Value (Rs.) Consignor Invoice Railway Receipt/ Bill of Lading/ Air Note No. Date No. Date (7) Amount of TVAT/ CST paid (with Challan No. & Date) : ................................ (8) Details of 'C' Form / 'F' Form used for the consignment (if any) :............................... (9) Remarks (if any) : ................................ I/We hereby declare that the above statement are true to the best of my/our* knowledge and belief. I/We have deposited the tax as per provisions of Tripura Value Added Tax Act, 2005. I/We, registered under CST Act, 1956 vide No.......................................................do hereby undertake to duly account for the disposal of above consignment and pay tax as per provision of CST Act. Name of the dealer (in full) : ................................. Signature and status of the Applicant : ................................. PERMIT No.: ..................... I hereby permit to transport the consignment detailed above. Seal Signature of the Superintendent of Taxes Date : Charge : .......................
