FORM 15

[See Rule12(i)(ii)]

Certificate of registration of persons liable for tax deduction at source

No............

This is to certify that the Proprietor/Partner/Principal Officer/Agent/Manager/Head of Office of the Establishment/ Firm/Club/ Association/Society/ Corporation/ Company known as ........ located at........ been registered under Section 18 of the Chhattisgarh Value Added Tax Act. 2005.

The holder of the certificate is liable for tax deduction at source for supplies/contracts of the nature..........

Seal

Place..............

Signature................

Date..............

Designation ..............