FORM XXI

[ See rule 28(A)]

I , .......................................... who am / is .............................. of ............................... who is employer holding a Registration Certificate No. ............................. dated ........................ hereby appoint Shri ....................... who is

to attend on *my behalf / behalf of the said ............................................ before ...................................................... ( State the Profession Tax Authority ) in the proceedings (describe the proceedings) before the said ........................... State the Profession Tax Authority and to produce accounts and documents and to receive on *my behalf / *behalf of the said # ............................. any notice or documents issued in connection with the said proceedings and to take all necessary steps in the said proceedings .

The said Shri .................................... is also hereby authorised to act *my behalf / behalf of the said @ .............................. in the said proceedings .

I agree ................................................. to ratify all acts done by.

The said .............................................. agrees the said Shri ..................................................... in pursuance of this authority.

ACCEPTANCE

I, ........................................................... do here by state that I am a relative of ......................................................... a person regularly employed by .......................................... a legal practitioner .................................................. a Chartered Accountant ...................................... a sales Tax Practitioner duly qualified under section 82 of the Maharashtra Value Added Tax Act, 2002 and that I accept the aforesaid appointment.