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

(See sub-rule(3)of rule 26 and rule 29)

Form of Certificate for Import

ORIGINAL

Book No.--------	S.No.----------------
	Sector--------Circle------------
	Date of issue--------------------
	Valid upto-----------------------

Certified that Shri / Sarvshri---------------------------------------------------------------------

(name and full address)

is/are hereby permitted to transport the consignment detailed below, to the extent of a maximum amount of Rs-------------------(Rupees-----------------------------------------------------)

Sl.no.	Description of goods	Quantity

		Signature
	(Seal)	and designation of
		the issuing officer

Certified that the goods covered by the above certificate have been purchased as per the details given below:

Sl.no.	Name and address of the dealer from whom goods are purchased	Bill/ Cash memo		Description of goods	Quantity/ Weight	Value of goods	Signature of selling dealer or Consigner
Sl.no.		Number	Date	Description of goods	Quantity/ Weight	Value of goods	Signature of selling dealer or Consigner
1	2	3(a)	3(b)	4	5	6	7

		Signature ---------------------
		Name:-------------------------
		Status:**----------------------
		(Purchasing dealer/ consignee)

		(Seal)

The above goods are being transported by

(1) Registration no. of the goods carrier.

(2) Name and address of the owner of the goods carrier.

(3) Name and address of Transport Company

		Signature -------------------
		of the vehicle driver
		Full name.-------------------
		Parentage ------------------
		Driving License No.--------

FORM XVII

(See sub-rule(3)of rule 26 and rule 29)

Form of Certificate for Import

DUPLICATE

Book No.--------	S.No.----------------
	Sector--------Circle------------
	Date of issue--------------------
	Valid upto-----------------------

Certified that Shri / Sarvshri---------------------------------------------------------------------

(name and full address)

is/are hereby permitted to transport the consignment detailed below, to the extent of a maximum amount of Rs--------------(Rupees----------------------------------------------------------)

Sl.no.	Description of goods	Quantity

		Signature
	(Seal)	and designation of
		the issuing officer

Certified that the goods covered by the above certificate have been purchased as per the details given below:

Sl.no.	Name and address of the dealer from whom goods are purchased	Bill/ Cash memo		Description of goods	Quantity/ Weight	Value of goods	Signature of selling dealer or Consigner
Sl.no.		Number	Date	Description of goods	Quantity/ Weight	Value of goods	Signature of selling dealer or Consigner
1	2	3(a)	3(b)	4	5	6	7

		Signature ---------------------
		Name:-------------------------
		Status:**----------------------
		(Purchasing dealer/ consignee)

		(Seal)

The above goods are being transported by

(1) Registration no. of the goods carrier.

(2) Name and address of the owner of the goods carrier.

(3) Name and address of Transport Company

		Signature -------------------
		of the vehicle driver
		Full name.-------------------
		Parentage ------------------
		Driving License No.--------

		Original copy received/retained

		Signatures ------------------
		* Officer In-charge Check Post
		Check Post-----------------------
		* Assessing Authority
		Sector----- Circle-----------------
		Date----------------

(*Strike out whichever is inapplicable )

FORM XVII

(See sub-rule(3)of rule 26 and rule 29 )

Form of Certificate for Import

COUNTER FOIL

Book No.--------	S.No.----------------
	Sector--------Circle------------
	Date of issue--------------------
	Valid upto-----------------------

Certified that Shri / Sarvshri---------------------------------------------------------------------

(name and full address)

is/are hereby permitted to transport the consignment detailed below, to the extent of a maximum amount of Rs--------------(Rupees----------------------------------------------------------)

Sl.no.	Description of goods	Quantity

		Signature
	(Seal)	and designation of
		the issuing officer

Certified that the goods covered by the above certificate have been purchased as per the details given below:

Sl.no.	Name and address of the dealer from whom goods are purchased	Bill/ Cash memo		Description of goods	Quantity/ Weight	Value of goods	Signature of selling dealer or Consigner
Sl.no.		Number	Date	Description of goods	Quantity/ Weight	Value of goods	Signature of selling dealer or Consigner
1	2	3(a)	3(b)	4	5	6	7

		Signature ---------------------
		Name:-------------------------
		Status:**----------------------
		(Purchasing dealer/ consignee)

		(Seal)

The above goods are being transported by

(1) Registration no. of the goods carrier.

(2) Name and address of the owner of the goods carrier.

(3) Name and address of Transport Company

		Signature -------------------
		of the vehicle driver
		Full name.-------------------
		Parentage ------------------
		Driving License No.--------