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THE PUNJAB VALUE ADDED TAX FORMS, 2005.
-

FORM VAT - 12

(See rule 30, 63 and 64)

Declaration at ICC or check post

Name of ICC
 
 		   ICC Code
 
 
Serial No.
 
 		   Import / Export
 
 
Serial No. of FORM VAT - 36
 
 		   Date :

Time :

    /     / 2 0    

 

DECLARATION

1. R.C. No. of the Consignor
                     
 
2. Name and Complete Address of the Consignor
 
 
3. R. C. No. of the Consignee
                     
 
4. Name and Complete Address of the Consignee
 
 
 
5. Description of Goods
 
 
6. Name and Address of the Transport Company
 
 
7. GR /TR /Way Bill/Log Book/Trip Sheet Number
 
 
8. GR/TR/Way Bill/Log Book/Trip Sheet Date
    /     / 2 0    
 
9. Vehicle Number
 
 
10. Name and Address of the owner of the person incharge of goods
 
 
11. Bill / Delivery Challan Number
 
 
12. Bill / Delivery Challan Date
    /     / 2 0    
 
13. Value of Goods
Rs.
 
14. Destination of Goods
 
 

Signature of the Officer-incharge along with his Code No. and Stamp appended after the check. Signature or thumb impression of the person transporting the goods.