THE ODISHA GOODS AND SERVICES TAX FORMS 2017
ASSESSMENT

Form GST ASMT - 01

[See rule 98(1)]

Application for Provisional Assessment under section 60

1.GSTIN
2. Name
3. Address

4. Details of Commodity / Service for which tax rate / valuation is to be determined
Sr. No.	HSN	Name of commodity /service	Tax rate				Valuation	Average monthly turnover of the commodity / service
Sr. No.	HSN	Name of commodity /service	Central tax	State/ UT tax	Integrated tax	Cess	Valuation	Average monthly turnover of the commodity / service
1	2	3	4	5	6	7	8	9


5. Reason for seeking provisional assessment
6. Documents filed

7. Verification-

I____________hereby solemnly affirm and declare that the information given hereinabove is true and correct to the best of my knowledge and belief and nothing has been concealed therefrom.

	Signature of Authorized Signatory
	Name
	Designation / Status--------
	Date-----------