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

Application for deferment under section 96 of the Bihar Value Added Tax Act, 2005

[See rule 57(2)]

Office of the __________________ of Commercial Taxes _________________ Circle

To,

The___________________

______________________circle.

I _______________________ (full name), son of ____________________ (full name) hereby apply for the grant of a deferment under section 96 of the Bihar Value Added Tax Act, 2005 and furnish the following particulars for that purpose -

1	Name and style of business-	.......................................................................................
		.......................................................................................
2	Taxpayer Identification Number-	.......................................................................................
3	Notification number under which exemption from tax under clause (b) of sub-section (3) of section 7 of the Bihar Finance Act, 1981 was granted	.......................................................................................
4	Certificate number and date under which exemption from tax under clause (b) of sub-section (3) of section 7 of the Bihar Finance Act, 1981 was granted	.......................................................................................
4	(attach copy)
5	Period/Quantum of entitlement admissible vide certificate mentioned at serial number 4 above
	(a) Date till which exemption admissible	.......................................................................................
	(b) Monetary ceiling	.......................................................................................
6	Amount of exemption already availed on the appointed date	.......................................................................................
7	Quantum of unavailed entitlement in terms of the explanation to rule 57	.......................................................................................

DECLARATION

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 ____________________________________________________________

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.

ACKNOWLEDGEMENT

Received on_________________ from _______________________ an application in Form A-XII for deferment of tax payable under the Bihar Value Added Tax Act, 2005.

Signature _____________________

Designation ___________________