Name of the Transporter ................................ Registration No. .............................................. Report for quarter ending ............................... FORM IX TRIPURA VALUE ADDED TAX ACT, 2004 Statement of Stock of undelivered consignments ( Under Rule 17(7) of the TVAT Rules ) Permit No. in Form XXIV with date of CRB Checkpost. C.N.No. with date Description of goods. No. of Packages Weight / Quantity Declared value Name of the Consignor Name of the Consignee Remarks 1 2 3 4 5 6 7 8 9 I/We hereby declare that the above statements are true to the best of my/our knowledge and belief. Signature of authorised signatory
