Bihar Value Added Tax Rules, 2005 FORMS
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A-XI

Intimation under section 15 of the Bihar Value Added Tax Act, 2005

(See rule 11)

To,

The ...............................

.......................................... Circle.

I .........................................(full name), son of ................................. (full name) hereby

submit this information under subsection (1)/(4)/(5)(a) (strike out which ever is not applicable) of the Value Added Tax Act, 205 and through following particulars for that purpose:

1. Name & Style of business-

2. Taxpayer Identification Number (TIN)-

3. Gross Turn over during the immediately proceeding year (Applicable to dealers opting to pay tax under sub-section (1) of section 15 of the Act)-

4. License No. under the Mines & Mineral (Development and Regulation) Act, 1957 (Applicable to dealers exercising their option under sub-section (4) of section 15)-

5. Proof of payment of tax in lieu of tax payable under the Act (Applicable to dealer exercising option under sub-section (4) of section 15-

Amount Rs........................ challan No..................................date ..........................

Declaration

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

I further declare that I am not a manufacturer of any goods other than bricks and that I shall inform the Department as soon as I purchase/receive any goods other than those required by me in the manufacture of bricks from outside Bihar.

Place....................	Signature of the applicant....................
Date....................	Status in relation to the dealer..............
	Permanent address.................................

The application shall be signed by the proprietor of the business if an individual; by the Kart, 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.

Acknowledgement

Received on ............................... from .................... an application in Form A-XI for permission to pay tax under section 15 of the Bihar Value Added Tax Act, 2005.


	Signature...................................
	Designation................................