THE HARYANA VALUE ADDED TAX - FORMS
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Body

FORM VAT-CD1

(See rule 49A (5))

Application for opting Lump Sum Composition Scheme in respect of Developers under rule 49A of the Haryana Value Added Tax Rules, 2003.

The Assessing Authority,

Ward/Circle No. Date:_____________

Serial Number	Original/Duplicate copy of application
1	Name of the Dealer
	PAN
	Mobile/Telephone No.
	E-mail id
	SCO/Booth/ Shop/ Building/ Flat/ Floor No.
	Building Name /Mohalla/Colony/ Market Place/Street/Lane
	Sector/Area
	City/Town/Village
	Post Office
	District
	Pin code
	State
2	TIN
	Date of Liability of TIN
	Date of Validity of TIN

3
A	Details of goods purchased from within the State of Haryana on which Input Tax Credit is claimed and lying in the opening stock. See Rule 49 A(2) (i)
Serial Number	Goods liable to VAT at different rates i.e. @ (%)	Purchase Value of goods on which VAT has been paid	Input Tax claimed (in Rs.)	Additional Tax claimed, if any.	Total Input Tax Claimed
1	2	3	4	5	6
1	@ 5% (declared goods)
2	@ 5% (other than declared goods)
3	@ 12.5% (non scheduled goods)
4	@
5
	Total

B. Goods purchased/received from outside the State of Haryana and lying in the opening stock. See Rule 49 A(2) (ii)

Serial Number	Goods liable to VAT at different rates i.e. @ (%)	Purchase/Receipt Turnover	VAT Payable @ 4% (in Rs.)	Additional Tax Payable	Total
1	2	3	4	5	6
1	@ 5% (declared goods)
2	@ 5% (other than declared goods)
3	@ 12.5% (non scheduled goods)
4	@
5
	Total

4	Details of Tax deposited as per Column 6 of Sr. No. 3(B)
Serial Number	Name of treasury where tax deposited or Bank on which DD/Pay order drawn or office from where RAO issued TDS	Treasury receipt (TR)/DD/PP/RAO				For office use
Serial Number		Type of Instrument	No	Date	Amount	DCR No	Date
(i)
(ii)
(iii)

Verification:

I,________________________________ (give full name) son/daughter of ________________________ (give name of the father), resident of _____________________ (give complete residential address), hereby declare in the capacity of _____________________ (proprietor/partner/managing director/duly authorized signatory) of M/s ___________________ (give full name of the business entity/dealer), having its business address at _________________ (give complete address of the dealer). I do hereby submit application to opt for the Lump Sum Composition Scheme in respect of developers under Rule 49A of the HVAT Rule, 2013.

	Signature
Place:
Date:	(Name of the dealer/authorised signatory)
	Also affix Seal and stamp of the dealer

ACKNOWLEDGEMENT

The undersigned acknowledge having received the original of this application for opting lump sum composition scheme from M/s._______________________ having TIN: _______________ on the date mentioned below:

(1) Date of receipt of return: _____________

(2) Signature with stamp of name and designation of receiving officer: _____________