Sl No.-

Form of declaration under section 15(5) of the Bihar Value Added

Tax Act, 2005.

(See rule 19(3A))

Sl No.-

Form of declaration under section 15(5) of the Bihar Value Added

Tax Act, 2005.

(See rule 19(3A))

Sl No.-

Form of declaration under section 15(5) of the Bihar Value Added

Tax Act, 2005.

(See rule 19(3A))

(To be retained by the selling dealer)

Book No. ---------- Serial No. ------

I/We ----------------- (name and style of Business), Taxpayer identification No. ---------- do hereby declare that I/We have sold -------(goods) the details whereof are given below to M/s. ------------ of ----------- (full address) bearing Tax payer identification No.-------. Period (Quarter):

*Gross value of goods sold Rs:

* Debit Notes issued: Rs.

* Credit Notes: Rs.

(*Attach herewith a detailed and signed statement mentioning the serial number of the document issued, date of its issue, amount for which issued and amount of tax involved separately in respect of the applicable invoices or debit notes or credit notes, as the case may be)

2. I/We further declare that the goods were subjected to tax on their maximum retail price at the point of sale in Bihar by me/us/ by M/s --------------- (Name and style) bearing Taxpayer Identification No.---------).

Signature and status of the person signing the declaration.

Place ------------------------

Date -------------------------

(To be appended to the return by the purchasing dealer)

Book No. ---------- Serial No. ------

I/We ----------------- (name and style of Business), Taxpayer identification No. ---------- do hereby declare that I/We have sold -------(goods) the details whereof are given below to M/s. ------------ of ----------- (full address) bearing Tax payer identification No.-------. Period (Quarter):

*Gross value of goods sold Rs:

* Debit Notes issued: Rs.

* Credit Notes: Rs.

(*Attach herewith a detailed and signed statement mentioning the serial number of the document issued, date of its issue, amount for which issued and amount of tax involved separately in respect of the applicable invoices or debit notes or credit notes, as the case may be)

2. I/We further declare that the goods were subjected to tax on their maximum retail price at the point of sale in Bihar by me/us/ by M/s --------------- (Name and style) bearing Taxpayer Identification No.---------).

Signature and status of the person signing the declaration.

Place ------------------------

Date -------------------------

(To be retained by the purchasing dealer)

Book No. ---------- Serial No. ------

I/We ----------------- (name and style of Business), Taxpayer identification No. ---------- do hereby declare that I/We have sold -------(goods) the details whereof are given below to M/s. ------------ of ----------- (full address) bearing Tax payer identification No.-------. Period (Quarter):

*Gross value of goods sold Rs:

* Debit Notes issued: Rs.

* Credit Notes: Rs.

(*Attach herewith a detailed and signed statement mentioning the serial number of the document issued, date of its issue, amount for which issued and amount of tax involved separately in respect of the applicable invoices or debit notes or credit notes, as the case may be)

2. I/We further declare that the goods were subjected to tax on their maximum retail price at the point of sale in Bihar by me/us/ by M/s --------------- (Name and style) bearing Taxpayer Identification No.---------).

Signature and status of the person signing the declaration.

Place ------------------------

Date -------------------------