GOVERNMENT OF JHARKHAND

COMMERCIAL TAXES DEPARTMENT

Application for Deferment u/s 95(3) of the Jharkhand VAT Act, 2005

[See Rule 64(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 95(3) of the Jharkhand 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 deferment / exemption from tax under Section 23A or under clause (b) of sub-section (3) of section 7 of the Adopted Bihar Finance Act, 1981 respectively, was granted -

4. Certificate number and date by which deferment / exemption from tax under Section 23A or under clause (b) of sub-section (3) of section 7 of the Adopted Bihar Finance Act, 1981 was granted (attach copy) -

5. Period/Quantum of entitlement admissible vide certificate mentioned at serial number 4 above -

(a) Date till which deferment / exemption is admissible -

(b) Monetary ceiling for availment of the facility -

6. Amount of deferment / exemption already availed as on the appointed date -

7. Quantum of unavailed entitlement in terms of Rule 64 -

DECLARATION

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