Bihar Value Added Tax Rules, 2005 FORMS
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Form D-IV

Form of declaration to be issued by transferor under the Bihar Value added Tax Act, 2005

Form D-IV

Sl No. ...........

Form of declaration to be issued by transferor under the Bihar Value Added Tax Act, 2005

See Rule 12 (5)

Counterfoil

Name of issuing dealer ------------------------------- along with his TIN -------------------------------------

---------------------------------------------- (transferee)

Taxpayer identification No.. ----------------------

1. Certified that goods transferred by me/us as per details below are inputs purchased by me from inside the state of Bihar.

Quantity and/ or weight

Value of goods -----------

No. & date of challan under which goods sent -------------------------------

Mode of transport with vehicle No-------------------.

No. & date of R.R. or lorry challan or any other documents indicating means of transport-------------

2. Certified also that I have paid tax amounting to Rs --------------------------------------

(Rupees--------------------------------------) at the time of purchase of aforementioned goods from M/s----------------------------------------------bearing Taxpayer Identification No.---------------

The above statement are true to the best of my knowledge & belief

Signature.

Dated----------------------

status----------------------

(Name of the person signing the declaration with status)

Note: To be retained by the transferor.

Signature

Status ---------------------------

Form D-IV

Sl No. ...........

Form of declaration to be issued by transferor under the Bihar Value Added Tax Act, 2005

See Rule 12 (5)

Original

Name of issuing dealer -------------------------------

Along with his TIN --------------------------------------

-------------- (transferee)

Taxpayer identification No.. -----------

1. Certified that goods transferred by me/us as per details below are inputs purchased by me from inside the state of Bihar.

Quantity and/ or weight

Value of goods -----------

No. & date of challan under which goods sent --------------------------------

Mode of transport with vehicle No-----------------.

No. & date of R.R. or lorry challan or any other documents indicating means of transport------------------------

2. Certified also that I have paid tax amounting to Rs--------------

(Rupees--------------------------------------) at the time of purchase of aforementioned goods from M/s-----------------------------------------------bearing Taxpayer Identification No.------------------

The above statement are true to the best of my knowledge & belief

Signature.

Dated-------------------

status------------------

(Name of the person signing the declaration with status)

Note: To be given to the transferee.

Signature

Status ----------------

Form D-IV

Sl No. ...........

Form of declaration to be issued by transferor under the Bihar Value Added Tax Act, 2005

See Rule 12 (5)

Duplicate

Name of issuing dealer -------------------------------

Along with his TIN --------------------------------------

-------------- (transferee)

Taxpayer identification No.. ---------

1. Certified that goods transferred by me/us as per details below are inputs purchased by me from inside the state of Bihar.

Quantity and/ or weight

Value of goods -----------

No. & date of challan under which goods sent -------------------------------

Mode of transport with vehicle No---------------.

No. & date of R.R. or lorry challan or any other documents indicating means of transport-------------

2. Certified also that I have paid tax amounting to Rs--------------

The above statement are true to the best of my knowledge & belief

Signature.

Dated--------------------

status--------------------

(Name of the person signing the declaration with status)

Note: To be given to the transferee.

Signature

Status --------------------

* Strike out which is not applicable	* Strike out which is not applicable	* Strike out which is not applicable
**The declaration shall be signed by the proprietor of the business, if a proprietorship, karta if an undivided Hindu family; by an authorised partner, in the case of a firm; by the managing director, managing agent, or the principal executive officer, in the case of a company, by the principal executive officer or officer incharge in the case of a society, club or association, department or local authority, or by the manager, if any declared by one of these under section 22 of the Bihar Value Added Act 2005.	**The declaration shall be signed by the proprietor of the business, if a proprietorship, karta if an undivided Hindu family; by an authorised partner, in the case of a firm; by the managing director, managing agent, or the principal executive officer, in the case of a company, by the principal executive officer or officer incharge in the case of a society, club or association, department or local authority, or by the manager, if any declared by one of these under section 22 of the Bihar Value Added Act 2005.	**The declaration shall be signed by the proprietor of the business, if a proprietorship, karta if an undivided Hindu family; by an authorised partner, in the case of a firm; by the managing director, managing agent, or the principal executive officer, in the case of a company, by the principal executive officer or officer incharge in the case of a society, club or association, department or local authority, or by the manager, if any declared by one of these under section 22 of the Bihar Value Added Act 2005.