Bihar Value Added Tax Rules, 2005 FORMS
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Form A-I

Application for registration under section 19(3) of the Bihar Value Added Tax Act, 2005

(See rule 3)

Office of the ____________________ of Commercial Taxes ____________-- Circle

To,

The __________________

__________________circle.

I ________________ (full name), son of ____________________ (full name) hereby apply for the grant of a registration certificate under section 19, of Bihar Value Added Tax Act, 2005 and furnish following particular for that purpose-

1.	Name and style of business-	.......................................................................................................
		.......................................................................................................
2.	Address-	.......................................................................................................
		.......................................................................................................
	(Give details of house number/Shop number/ Locality/ Post office/ Police station/District etc.)
3.	Legal states of the business-	.......................................................................................................
3.	(Whether individual/ HUF/Firm/ Company/Society/ Club/Association/ Government department/ Corporation etc.)
4.	Nature of business	.......................................................................................................
4.	(Whether manufacturer/ C & F agent/ Distributor/ Whole seller/ Retailer/ Works contractor etc.)
5.	Particulars of additional places of business-
	(Attach list separately; if necessary)
	(a) Head office	.......................................................................................................
	(b) Branch offices	.......................................................................................................
	(c) Godowns	.......................................................................................................
6.	Particulars of any C & F agency/ any other purchasing or selling agency held by the dealer-
	(Attach list separately; if necessary)
	.................................................................................................................................................................................
	.................................................................................................................................................................................
7.	Particulars of business, other than the business in respect of which this application is being made, in which dealer has/had any interest-
	(Attach list separately; if necessary)
	.................................................................................................................................................................................
	.................................................................................................................................................................................
8.	Date of liability	.......................................................................................................
9.	Particulars of all immovable properties owned by all persons having interest in the business- (Attach list separately; if necessary)
	.................................................................................................................................................................................
	.................................................................................................................................................................................
10.	Name of bank/ banks through which transactions are carried out with account number and nature of accounts-
	.................................................................................................................................................................................
	.................................................................................................................................................................................
11.	Telephone number/ Fax number/	.......................................................................................................
	E-mail	.......................................................................................................
12.	PAN	.......................................................................................................
13.	Particular relating to registration, license, permit etc. granted under any other law- (Attach list separately; if necessary)
	.................................................................................................................................................................................
	.................................................................................................................................................................................
14.	Particulars of goods purchased/ sold/ manufactured by the dealer- (Attach list separately; if necessary)
	.................................................................................................................................................................................
	.................................................................................................................................................................................

VERIFICATION

I do hereby declare that the particulars furnished in this application are correct and complete to the best of my knowledge and belief.

Place __________________	Signature of the applicant _____________________
Date __________________	Status in relation to the dealer __________________
Permanent address _________________________________________________________

CERTIFICATE

I ________________________ (full name) certify that the above named has been selling goods since ________________ (give period) at the address given in item 2 of this application.

Place __________________	Signature _________________________________
Date __________________	Status or designation ________________________

The application shall be signed by the proprietor of the business if an individual; by the Karta, if an undivided Hindu family; by an authorized partner in the case of a firm; by a managing director, managing agent or principal executive officer in the case of a company or corporation; by the Principal executive officer-in-charge of in the case of a society, club, association, department of Government or local authority.

The certificate shall be given either by a legal practitioner or by a dealer registered under the Bihar Value Added Tax Act, 2005 doing business in the same locality or a Municipal Commissioner of the area or a Mukhiya of the Gram Panchayat of the area or a gazetted officer having jurisdiction over the area.

No such certificate need be furnished in the case of a Government Department or local authority.