THE HARYANA VALUE ADDED TAX - FORMS
-

Body

FORM VAT C-4

[See rule 20 (1), (2) and (3)]

CERTIFICATE

Certificate to be issued by a selling VAT dealer to a purchasing VAT dealer in respect of taxable goods for claim of input tax under sub-section (3) of section 8.

Certified that I/We…………………………………………… (Name and complete address of the selling dealer) having Taxpayer Identification Number (TIN)………………… under the Haryana Value Added Tax Act, 2003 in District…………… (i) have paid the full amount of tax under the Haryana Value Added Tax Act, 2003 vide TR No…… Date………… (ii) have adjusted the input tax paid to M/s ………………………… (Name and complete address of the selling dealer) holding TIN……………… on the goods sold to M/s ………………………… and complete address of the purchasing dealer) holding TIN……………… as per tax invoice(s) stated below:-

Sr. No.	Description of goods sold	Tax Invoice No.	Date	Taxable Amount	Amount of tax


Total

1	Total taxable amount:-Rs……………
2	Total amount of tax:- Rs……………..
Place:………………….
Date:………………….	Signature of the selling VAT dealer
	Name……………………
	Status……………….
Stamp of the Dealer
	(office seal.)

*Note: 1. Original copy to be issued by the selling dealer to the purchasing dealer

2. Duplicate copy to be retained by the selling VAT dealer.

3. Strike out whichever is not applicable.".