THE HIMACHAL PRADESH VALUE ADDED TAX RULES, 2005. FORMS
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Body

FORM-VAT VI-A

[See rule 59 A]

APPLICATION FOR REGISTRATION OF CARRIER OF GOODS/ COURIER AGENT/ PERSON IN-CHARGE OF GOODS

Affix Passport

size Photograph of

applicant

I, ..................................Principal officer, son of Sh./ Smt............... on behalf of the transporter, carrier or transporting agent carrying on transport business in Himachal Pradesh, whose particulars are given below, hereby apply for registration under Section 35 of the Himachal Pradesh Value Added Tax Act, 2005

1. Name with full postal address of the transporter, courier or transporting agent with Telephone number and email id, if any:-

(i)	Name:
(ii)	Address:
(iii)	Telephone No:
(vi)	E-mail:

2. Name, designation and address of principal officer or a manager in-charge of the affairs of the business:-

(i)	Designation:
(ii)	Address:

3. Location of the principal office/ place of business in Himachal Pradesh:-

(i)	Name of the building if any:
(ii)	(Ward No.:
(iii)	Name of the Town/ Village:
(vi)	Post Office:
(v)	District:

4. Location or branches/ other places of business (a separate sheet may be enclosed, if necessary) :-

Particulars of branches	Branch-I	Branch-II	Branch-III
(i) Name of the building, if any (ii) Ward No. (iii) Name of the road/street (iv) Name of the town (v) Post Office (vi) District

5. Location of godowns/ warehouses:- (attach separate sheet, if necessary)

(a) For principal office

Name of the principal office	Location of godowns
	Godown-I	Godown-II	Godown-III

(b) For branch(es)

Name of the Branch	Location of godowns
	Godown-I	Godown-II	Godown-III

Date of commencement of business

Style of business (proprietorship/ partnership/ company/co-operative society/club/ Association of persons/H.U.F/Govt. Department/ Public Sector Undertaking etc.

PAN No.

Service Tax Number

10. Name(s) and address(es) of the Proprietor/Partners/ Directors/Members/Karta /Head of Office etc.:-

Sl. No.	Name	Father's/ Husband Name	Designation	Age	Permenant Address	Present Address	Signature
1
2
3
4
5

11. Details of Bankers, with following particulars:-

Sl. No.	Name & address of the Bank Branch	In whose name the account stands	Whether saving or current account	Account Number

Full Address of the Principal Head Office, if situated outside Himachal Pradesh

The language in which books of accounts are maintained

The accounting year followed by the applicant

Full address of the place where books of Accounts are kept

16. Detail of Security Furnished

Sl. No.	Type of security	Name of the surety (if applicable)	Amount	Name and TIN of the business in which surety has an interest if any.	Date of expiry (in case of FDR)

I do hereby solemnly declare that the above statements are true to be best of my knowledge and belief.

Place________	Signature
	Designation