FORM VAT 120

GOVERNMENT OF JHARKHAND

COMMERCIAL TAXES DEPARTMENT

Application for Grant of Certificate for Non-Deduction of Tax from Bills of a Supplier / works contractor registered under the Jharkhand Value Added Tax Act, 2005

[See Rule 24]

Office of the ------------------------------ of Commercial Taxes -------------------- Circle

To,

The-----------------------------

---------------------------- Circle.

I ------------------------ (full name) son of ----------------------------- (full name) hereby apply for the grant of certificate in Form JVAT 407 under Rule 24 of the Jharkhand Value Added Tax Rules, 2006 and furnish the following particular for that purpose...

1. Name and style of the firm / works contractor*-

2. Taxpayer Identification Number-

3. TDN of authority / person / contractee* to whom the goods are to be supplied / works executed

4. Name and complete address of the authority / person / contractee* to whom the goods are to be supplied / works executed* -

5. Value of the goods to be supplied / valuable consideration of works contract* (Attach copy of the each work contract / order) -

6. I am holder of the Registration Certificate in Form JVAT 106/ Form JVAT 108.

DECLARATION

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

I further declare that tax payable in regard to the supplies / valuable consideration / composition tax* mentioned at serial number 4 / 5 above shall be deposited by me in __________________ (Name of the circle) as and when the tax thereon becomes due for payment.

* Please ("Tick") the appropriate