THE MAHARASHTRA STATE TAX ON PROFESSIONS TRADES, CALLINGS AND EMPLOYMENTS RULES, 1975. - FORMS
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Form XIV A-1

[See rule 22(1A)]

Application for obtaining Authorisation for working as a Recovery Agent under the Maharashtra State Tax on Professions, Trades, Callings and Employments Act, 1975.

To,

The Commissioner of Professions Tax,

Maharashtra State, Mumbai

Sir,

I, the undersigned Shri/Smt. ..................................................................................................
	(Surname)	(Name)	(Father's/Husband's name)

Hereby apply for obtaining authorisation for working as a Recovery Agent under the Maharashtra State Tax on Professions, Trades, Callings and Employments Act, 1975 (Mah. XVI of 1975).

My particulars are as under :

(1) Name in Full	:
(2) Designation	:
(3) Office Address	:
(4) Name and designation of the Officer under whom the Applicant's is working	:
(5) Experience of working	:

I hereby state that I shall follow the provisions of the law and rules framed by the Government and the instructions given by the Profession Tax Authorities/while discharging my duties as a Recovery Agent.

Place :
Date :	Signature and Name in Full".

VERIFICATION

I, Shri / Smt. ...................................................................................... hereby declare that whatever is stated above is true to the best of my knowledge and belief.

Verified this ......................................... (date) day of .............................................. (month) .................................. (year) at ........................................... (place).


	Signature and Name in Full

Acknowledgement

Received Application for Authorization to work as Recovery Agent from Shri/Smt............................ on ................................ (date) at .................................. (place).


	Office Stamp and Signature of the Receiver