FORM - I THE TRIPURA VALUE ADDED TAX ACT, 2004 APPLICATION FORM FOR REGISTRATION (Under Rule 10 of TVAT Rules) Write clearly in black ink and use BLOCK LETTERS To The Superintendent of Taxes Charge No................ Affix a Photograph of the Signatory 1. Name of the Applicant : Family Name First Name Middle Name 2. Sex : Male / Female 3. Trade Name of the Business : ____________________________________ 4. Address : No. / Street : ____________________________________ City : ____________________________________ Pin Code : ______________ 5. Telephone No. : _____________ Fax No. : _____________E-Mail Id. : ______________ 6.(a) Partners in Firm, Chief Executive in Company, Co-operative. Etc. Sl.No. Name Designation Address Age Father's Name 6.(b) Interest (of Partners in Firm, Chief Executive in Company, Co-operative. Etc.) in other Business Sl.No. Name Firm's Name Address of the Firm Value Added Taxpayer's Identification Number (TIN) CST Registration No. 7. Address of All Branch Offices Sl.No. Branch Post Office Thana District 1. 2. 8. Location of factory (if any) Sl.No. Address Post Office Thana District 1. 2. 9. Location of Godowns (if any) Sl.No. Address Post Office Thana District 1. 2. 10. List of Taxable Items Dealing with Sl.No. Item Code Description Purchase From places within Tripura for Resale (Y / N) Manufacture Make and Process for Sale in Tripura (Y / N) Import/intend to import for Sale in Tripura Within India ( Y/N ) Outside India ( Y/N) 11. Economic Activity Code (Manufacturer/Importer/Reseller/Seller) :________________ 12. Particulars of Movable and Immovable Property Including Landed Property of Proprietors/ Partners Sl.No. Proprietor / Partner Name Property Type (Movable/Immovable) Details of Property 13. Information of Liability. Sl.No. Proprietor / Partner's Name Nature of liability Details of liability 14. Banker's Name : _____________________________________________________ Nature of Account Held :____________ Account Number : _____________ 15. Trade License Issued by Municipal : No. ______________ Date : ___________ Corporation / Nagar Panchayat 16. License Issued Under the : No. ______________ Date : ___________ Tripura Shops & Establishment Act 17. Food Staff License issued by the : No. ______________ Date : ___________ Competent Authority 18. Whether Citizen of India or Not (Y/N) : _________________ 19. PAN No. : __________________________________________________________ 20. Sale of Goods : Last Quarter : _____________________ Last Year : ____________ 21. Date of first Taxable sale : _____________________ 22. Language to be used in maintaining accounts : ______________________________ I __________________________________ (Proprietor/Director/Partner/Secretary or any authorised Person) hereby declare that the particulars given herein are correct and I hereby apply for registration for value added tax. Designation ...................... Introduced By : ______________________________________________________ (Registered Dealer or Any Responsible Person) FOR OFFICE USE ONLY Date of Registration : Day __________ Month ______ Year ______ Taxpayer's Identification Number : ___________________________________ Amount of Security Paid : (Rs.) __________________________________ Bank Scroll No. : ________________ Date ___________ Remarks, if any __________________________________________________
