FORM 12

[See Rule 18(2)]

Application for cancellation of registration certificate

I..........Proprietor/*Manager/Partner/Director/Officer-Incharge of the business known as.......Officer- Incharge of the business of selling or supplying goods carried on by the Central Government/State Government holding registration certificate No.........under the Chhattisgarh Value Added Tax Act, 2005 with his only/*principal place of business situated in Municipal Ward No.........(for municipal areas only) at...........in the tehsil.........of the district..........hereby state that :

*(a) I have discontinued my business from.........and had the following stock of goods with me on the said date :

Particulars of Stock with value of goods taxable under clause (i) of section 8 at _____%

Particulars of Stock with value of goods taxable under clause (ii) of section 8 at ______%

OR

*I have wholly transferred my business on.............to M/s. ...............of............holding registration certificate No..........(if any).

*(b) My gross turnover for the last two consecutive years preceding the current year as also for the current year (upto the date of application) was as under :

I, therefore, apply for cancellation of my registration certificate under clause (a)/*clause (b) of subsection (10) of section 16 of the said Act.

2. *As I have discontinued my business or wholly transferred my business, I herewith enclose my registration certificate with certified copies thereof for cancellation and blank statutory forms issued by the Commercial Tax department.

Encl :- (1) Registration Certificate along with the certified copies thereof.

(2) ------- blank statutory forms.

*Strike out whichever is not applicable.