THE RAJASTHAN GOODS AND SERVICES TAX FORMS 2017
COMPOSITION FORMS

Form GST - CMP-04

[See Rule 6(2)]

Intimation/Application for Withdrawal from Composition Levy

1. GSTIN

2. Legal name

3. Trade name, if any

4.Address of Principal Place of business

5. Category of Registered Person

(i) Manufacturers, other than manufacturers of such goods as may be notified by the Government

(ii) Suppliers making supplies referred to in clause (b) of paragraph 6 of Schedule II

(iii) Any other supplier eligible for composition levy."

6. Nature of Business

7. Date from which withdrawal from composition scheme is sought

YYYY

8. Jurisdiction

Centre

State

9. Reasons for withdrawal from composition scheme

10. 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
Place
Date	Designation / Status

Note - Stock statement may be furnished separately for availing input tax credit on the stock available on the date preceding the date from which composition option is withdrawn in FORM GST ITC -01.