THE UTTARAKHAND (THE UTTARANCHAL VALUE ADDED TAX RULES, 2005) FORMS
-

Body

"ACKNOWLEDGEMENT"

of form-IV (Amended)

(Annual Returns)

01- Serial No. of Acknowledgement

02- Date of Acknowledgement

03- Office Code of Sector/Range

04- Period of Return

From

05- TIN of The Dealer

06- Name and address of the dealer

07- Assessment Year

08-NTO (STATE)

(09)

09- GTO (STATE)

(13)

10-NTO (INTER STATE)

(16)

11- GTO (INTER STATE)

(20)

12- STATE "OUTPUT TAX"

(10)

13- INTER STATE "OUTPUT TAX"

(17)

14- ITC- CLAIMED

(34)

15- TOTAL AMOUNT DEPOSITED (with annual return)

(51)

16-LATE- FEE DEPOSITED (for late annual return)

(49)

17- TOTAL NO. OF PAPERS (including return annexure certificates/ declarations, challans other documents excluding Acknowledgement)

(83)

Received with thanks from M/s....................................................... a annual return for the above period in Form IV having following particulars:-

Signature

(Authorised Signatory)

Seal, Signature and Name of Receiving Official

Note: To be submitted in two copies duly filled. One copy to be returned with a Sl. No. Stamp and Sign of receiving official.

------------------

Form-IV (Amended)

[ U.K. VAT Act Section 25 (2) Rule 11 (16) ]

ANNUAL RETURN

01- TIN of The Dealer
02- Office Code of Sector/Range
03- Period of Return	To
04- Assessment Year
05- Name & address of the dealer

Computation of Own Final Assessment of Amount of Tax Due and ITC Claimed (As per Vat Act 2005 and CST Act 1956)

T.O. of State Sales .............. (taxable at general rate of tax)

SI. No	Name of Goods	Sch. No.	SI. No in Sch.	Turn over	Rate of Tax	Output Tax	Remark
i
06	Total (i+ii+......)

T.O. of State Purchase (taxable u/s 3(10) )

SI. No	Name of Goods	Sch. No.	SI. No in Sch.	Turn over	Rate of Tax	Output Tax	Remark
i
07	Total (i+ii+......)

T.O. of State Sales (taxable at concessional rate of tax & supported tax required declaration certificate other document)

SI. No	Name of Goods	Sch. No.	SI. No in Sch.	Turn over	Rate of Tax	Output Tax	No. of declarations certificates other documents submitted
i
08	Total (i+ii+......)

NTO (STATE)

06 + 07+ 08)

OUT PUT TAX (STATE)

06 + 07+ 08)

T.O. of State Sales (Conditionally exempt & supported by required declaration/ certificates/ other document)

SI. No	Name of Goods	Sch. No.	SI. No in Sch.	Turn over	General Rate of Tax	Output Tax	No. of declarations certificates other documents submitted
i
11	Total (i+ii+......)

T.O. of State Sales (UNconditionally exempt)

SI. No	Name of Goods	Sch. No.	SI. No in Sch.	Turn over	General Rate of Tax	Output Tax	Remark
i
12	Total (i+ii+......)

GTO (STATE)

(09+11+12)

T.O. of Inter State Sales (taxable at General Rate of Tax)

SI. No	Name of Goods	Sch. No.	SI. No in Sch.	Turn over	Rate of Tax	Output Tax	Remark
i
14	Total (i+ii+......)

T.O. of Inter State Sales (taxable at concessional rate of tax supported by required declaration certificates other document)

SI. No	Name of Goods	Sch. No.	SI. No in Sch.	Turn over	Rate of Tax	Output Tax	No. of declarations certificates other documents submitted
i
15	Total (i+ii+......)

NTO (INTER-STATE)

(14+15)

OUT PUT TAX (INTER STATE)

(14+15)

T.O. of Inter State Sale transfer and export (Conditionally exempt & supported by required declarations certificates other document)

SI. No	Name of Goods	Sch. No.	SI. No in Sch.	Turn over	General Rate of Tax	Output Tax	No. of declarations certificates other documents submitted
i						00
18	Total (i+ii+......)					00

T.O. of Inter- State Sale/ transfer & Export (Unconditionally Exempt)

SI. No	Name of Goods	Sch. No.	SI. No in Sch.	Turn over	General Rate of Tax	Output Tax	Remark
i						00
19	Total (i+ii+......)					00

GTO (INTER STATE)

(16+18+19)

GTO ( STATE+ INTER STATE)

(13+20)

T.O. of State Purchases of Non Capital VAT Goods from registered dealers

SI. No	Name of Goods	Sch. No.	SI. No in Sch.	Purchase Value (before tax)	Rate of Tax	Input Tax	Amount of ITC claimed
i
22	Total (i+ii+......)

T.O. Of State Purchases of VAT goods from unregistered dealers.

SI. No	Name of Goods	Sch. No.	SI. No in Sch.	Purchase Value	General Rate of Tax	Remark	Remark
i
23	Total (i+ii+......)

T.O. of State Purchases of Capital goods from registered dealers.

SI. No	Name of Goods	Sch. No.	SI. No in Sch.	Purchase Value (before tax)	Rate of Tax	Input Tax	Amount of ITC claimed
i
24	Total (i+ii+......)

T.O. of State Purchases of Non VAT goods

SI. No	Name of Goods	Sch. No.	SI. No in Sch.	Purchase Value (before tax)	Rate of Tax	Input Tax	Remark
i
25	Total (i+ii+......)

T.O. of Inter- State Purchases of VAT & Non VAT goods from outside the State/consignment in.

SI. No	Name of Goods	Sch. No.	SI. No in Sch.	Purchase Value (including tax)	General Rate of Tax in UK	Remark	No. of Form- 16 used
i
26	Total (i+ii+......)

ITC Claimed

Amount

27	ITC on Non Capital Goods
28	ITC on Fuel
29	ITC on Opening Stock
30	ITC on Capital Goods
31	Total (27+28+29+30)

32	Reverse Tax Credit due to Stock Transfer (attached details & Computation in Annex-001
33	Reverse Tax Credit due to other reason (attached details & Computation in Annex-002)
34	ITC Claimed (31-32-33)

Tax Account

Amount

Total Output Tax (STATE)

=10

Tax Credit B/F

(from previous return)

36A

ITC Claimed (=34)

Tax Credit on sale return

(attached details)

(Annex-003)

Tax Credit for other reasons

(attached details)

(Annex-004)

TDS

(attached details)

(Annex-005)

39A

Tax deposited with Periodical Returns.

39B

Differential Tax deposited (47+48)

Total

(36+36(A)+ 37+38+39+39(A)+39(B))

Net tax payable (STATE)

(35-40)

Net tax in excess

(40-35)

Total Output tax (Inter- State)

Net CST Payable

(43-42)

Refund Claimed

(42-43)

Tax C/F

(42-43)

Payment of differential Tax interest, late fees and other dues.

Amount

	A/c Head	Challan Id Number (CIN) and Date	Bank's Name Address	Bank's MICR Code	Tax deposited (Rs.)
i	0040001020100 (VAT)
ii	0040001020100 (VAT)
47	Tax Deposited (State)	Total (i+ii......)

i	0040001010100 (CST)
ii	0040001010100 (CST)
48	Tax Deposited (CST)	Total (i+ii......)

i	0040008000100 (L. Fee)
49	Late Fee Deposited	Total (i+ii......)

i	0040008000100 (Int.)
ii	0040008000100
50	INTER ST. & OTHER DUES DEPOSITED	Total (i+ii......)

TOTAL AMOUNT DEPOSITED

(48-49-50-51)

(In Words)

Submission of declaration forms certificate for concession, rebate or exemption

Description of declaration forms certificates/ documents

No. of such forms certificate/ documents submitted

List to be submitted in the following prescribed Annexure

52- Form XI

(STATE)

Annexure-006

53-Form- C

(CENTRAL)

Annexure-007

54-Form-H

(CENTRAL)

Annexure-008

55-Form-I

(CENTRAL)

Annexure-009

56-Form-J

(CENTRAL)

Annexure-010

57-Form-F

(CENTRAL)

Annexure-011

58-Form-E:1

(CENTRAL)

Annexure-012

59-Form-F:2

(CENTRAL)

Annexure-013

60- Bill of lading Air consignment note other document in support of export

Annexure-014

61- other certificates

Annexure-015

62- Total (52+53+54+55+56+57+58+59+60+61)

63- Value of Opening and Closing Stocks	Annexure- 016
64- A true copy of Audit report as required under sec-62 of the Act	Annexure- 017
65- Reason of difference with total of the Perioddical Returns	Annexure- 018
66- List of Tax (State) Charged by the Registered dealers for which ITC has been claimed	Annexure- 019 (A)
67- List of tax (State) realised from Registered dealers	Annexure- 019 (B)

Details of utilization of Froms, Stamps received from the office in the prescribed Annexure-

Description of declaration forms/ certificates/ documents	Op. balance	Recd. During the Assessment year	Consumed during the Assessment year	Returned during the Assessment year	Lost during the Assessment year	Cl. balance	List to be submitted in the following prescribed Annexure
68-Form-16 (STATE)							Annexure- 020
69-Form-C (CENTRAL)							Annexure- 021
70-Form-H (CENTRAL)							Annexure- 022
71-Form-I (CENTRAL)							Annexure- 023
72-Form-J (CENTRAL)							Annexure- 024
73-Form-F (CENTRAL)							Annexure- 025
74-Form-E: 1 (CENTRAL)							Annexure- 026
75-Form-E: 2 (CENTRAL)							Annexure- 027
76-Form-XI (STATE)							Annexure- 028
77-Form-8 (STATE)							Annexure- 029
78-OC Stamps (STATE)							Annexure- 030

79- Details of due periodical tax, interest, TDS, late fees and other dues	Annexure-031
80- List of Annexure submitted	Annexure-032
81- Proof of deposit of differential tax, interest, fees, TDS, other dues submitted (Annexure no, to be self alloted in increasing no.)	Annexure- Annexure- Annexure-
82- Description other Annexure submitted (Annexure no, to be self alloted in increasing no.)	Annexure- Annexure-

Note: Only those Annexure are to be submitted which are applicable

83- Total no. of papers (including return, annexue, certificates/ declaration, challans and other documents excluding "Acknowledgement")

Declaration

I.....................................................................S/o............................................... am authorized to sign this return and I do hereby declare and verify that, the information and particulars given in this return are true and complete and nothing has been willfully omitted or wrongly stated and that all the required annexure an challans are enclosed/attached.

	Sign. of Auth. Signatory ............
	Name of Auth. Signatory ............
	Father's Name ............
Date............	Status of Auth. Signatory ............

Note: Only those annexure are to be submitted which are applicable.