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

(See sub-rule (1) of rule 22 )

APPLICATION FOR RECOGNITION CERTIFICATE UNDER SUB-SECTION (7) OF SECTION 4 OF THE UTTARANCHAL VALUE ADDED TAX ACT, 2005

To,

The Assessing Authority, Commercial Tax

Sector__________Circle___________

1-(a) Name of applicant:	---------------------------------------------------------------------------------
(b) Father's /Husband's name:	---------------------------------------------------------------------------------
(c ) Residential address:	---------------------------------------------------------------------------------
(d) Status in business :	---------------------------------------------------------------------------------
2-Name and style of business -	---------------------------------------------------------------------------------
3- Principal place of business : In Uttaranchal with complete address:	---------------------------------------------------------------------------------
	--------------------------------------------------------------------------------- Tel.Ph.No.----------------Fax------------------e-mail----------------------
4- Registration Number-
(a) Uttaranchal Value Added Tax Act, 2005	----------------------------------------
(b) Central Sales tax Act, 1956	---------------------------------------
5- Name and address of Registered/Head office, if situated outside Uttaranchal with Sales Tax Registration Nos.	--------------------------------------------------------------------------------- --------------------------------------------------------------------------------- --------------------------------------------------------------------------------- Registration No. (State) ----------------------- (C.S.T.) ----------------- Tel.Ph.No.----------------Fax------------------e-mail----------------------

6-Name and address of all other places of business including depots and branches in Uttaranchal:

Sl. No.	Address of business place	Name and complete address of owner of the premises	Telephone number	If rented premises
Sl. No.	Address of business place	Name and complete address of owner of the premises	Telephone number	Amount of rent per month	Date from which taken on rent
1-
2-
3-
4-

7-Description of goods to be manufactured in respect of which Recognition Certificate is sought;

Sr.No.	Code	Goods

8- Details of particulars of Proprietor/ Partners/ Members and Karta of Joint Hindu Family/ Trustee/ Receiver or Guardian of a minor or incapacitated person, or Directors and Principal Officers of Private Limited Company or Public Limited Company (as the case may be):

Personal details	(1)	(2)	(3)	(4)
1-Full name
2- Father's / Husband's name
3- Age
4-Present residential address
5-Permanent residential address
6- Status in business and extent of interest
7-PAN under Income Tax Act
8-Signature

Passport size photograph of the applicant to be affixed

DECLARATION

I, --------------------------------------------(applicant) do

hereby declare that the particulars furnished in this application are true and complete to the best of my knowledge and belief, and no material particular has been concealed.

Place :--------------------	Signature of the applicant ------------------------------
Dated:---------------------	Name : -------------------------------------------------
	Status in business -------------------------------------

	(SEAL)

WITNESS :	(1)	-------------------------------------	(2)	-------------------------------------
Signature		-------------------------------------		-------------------------------------
Name :		-------------------------------------		-------------------------------------
Parentage :		-------------------------------------		-------------------------------------
Full address :		-------------------------------------		-------------------------------------
		-------------------------------------		-------------------------------------

Signature and details of the person who has attested signature and photograph of the applicant

(SEAL)

Signature :

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

Name :

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

Status :

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

FOR OFFICE USE ONLY

RECOGNITION CERTIFICATE

Book No.---------

Sl.No.--------

This Recognition Certificate is hereby granted under sub-section(7)of section 4 of Uttaranchal Value Added Tax Act,2005 subject to the provisions of the Act and the rules, regulations and orders made thereunder and also the conditions specified herein to S/Sri-------------------------------------------------------------- (name of dealer)whose principal place of business is situated at ----------------------------------------------------------------------- ----------------------------(complete address of dealer) and is registered as a dealer under the Act and is allotted Registration Number 05________________

	There are the following branches:
	1------------------------------------------------------------------------------------------------
	2------------------------------------------------------------------------------------------------
	3-------------------------------------------------------------------------------------------------

Conditions for the grant of this Certificate

1-This Recognition Certificate shall be effective from ------------

2-The said Recognized dealer is authorized to purchase the goods required for the manufacture of the goods specified below on furnishing to the selling dealer of Uttaranchal a certificate under the provisions of the Act and the rules framed thereunder.

3-The goods purchased on the strength of this certificate shall be used only by the recognized dealer and only for the manufacture of the goods specified below.

4-The Recognised dealer shall produce this Certificate before the selling dealer whenever he is asked to do so.

5-This Recognition Certificate is liable to be amended or cancelled in accordance with the provisions of the Act and the rules made thereunder.

6-The Recognised dealer is authorized to purchase at concessional rates the Capital Goods and raw materials required for the manufacture of the following goods or in the packing of such manufactured goods;

Sr.No.	Code	Goods

Place ------------		Assistant Commissioner
Date-------------	OFFICE COPY	Sector-----Circle-----------
		(SEAL)