The Jharkhand Value Added Tax Forms , 2005
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GOVERNMENT OF JHARKHAND

COMMERCIAL TAXES DEPARTMENT

FORM JVAT 504 G

Form of Permit

[See Rule 42(2)(b)]

Name of the Printer/ Self Computer Printed (in Bold letters)

(Counterfoil - save as provided in sub-rule (10) of Rule 42 Not transferable)

Serial no.

(To be filled in by the permit-holder before Transport of Goods)

1. Name of dealer by whom the permit is issued with TIN Number.

2. Name and address of the consignor ...........................

3. Name and address of the consignee ...........................

4. Place of dispatch ....................................................

5. Destination .....................................................

6. Name of notified railway station/other place, from where delivery is to be taken ...............

7. Number and date of -

a. Railway receipt ....................................

b. Other document ....................................

8. Description of consignment -

Name of goods	value	quantity

9. Seller's invoice/forwarding note number and date ............

10. Mode of transport (vehicle no.) ....................................

I/We hereby declare that the above statements are correct and complete to the best of my/our knowledge and belief.

Signature of dealer/declared manager

Date ........................

RESULT OF CHECKING ON THE ROUTE

Designation and head quarters of the authority by whom transport of consignment was checked.	Description of goods	Quantity of the goods actually transported.	Dated signature of the authority mentioned in column I and place of checking
1	2	3	4

NOTE-(1) Separate form should be used for each consignment.

(2) (a) In case of transport across or beyond check-post, a copy of the form should accompany the consignment.

(b) In case of delivery of consignment from any notified railway station/other such place the original copy of the form shall accompany the consignment in transit and thereafter shall be sent to the appropriate authority of the Commercial Taxes.

Name of the Printer/ Self Computer Printed (in Bold letters)

(Duplicate - save as provided in sub-rule (10) of Rule 42 Not transferable)

Serial no.

(To be filled in by the permit-holder before Transport of Goods)

1. Name of dealer by whom the permit is issued with TIN Number.

2. Name and address of the consignor ...........................

3. Name and address of the consignee ...........................

4. Place of dispatch .....................................................

5. Destination .....................................................

6. Name of notified railway station/other place, from where delivery is to be taken ...............

7. Number and date of -

a. Railway receipt ....................................

b. Other document ....................................

8. Description of consignment -

Name of goods	value	quantity

9. Seller's invoice/forwarding note number and date ............

10. Mode of transport (vehicle no.) ....................................

I/We hereby declare that the above statements are correct and complete to the best of my/our knowledge and belief.

Signature of dealer/declared manager

Date ........................

RESULT OF CHECKING ON THE ROUTE

Designation and head quarters of the authority by whom transport of consignment was checked.	Description of goods	Quantity of the goods actually transported.	Dated signature of the authority mentioned in column I and place of checking
1	2	3	4

NOTE-(1) Separate form should be used for each consignment.

(2) (a) In case of transport across or beyond check-post, a copy of the form should accompany the consignment.

Name of the Printer/ Self Computer Printed (in Bold letters)

(Original - save as provided in sub-rule (10) of Rule 42 Not transferable)

Serial no.

(To be filled in by the permit-holder before Transport of Goods)

1. Name of dealer by whom the permit is issued with TIN Number.

2. Name and address of the consignor ...........................

3. Name and address of the consignee ...........................

4. Place of dispatch .....................................................

5. Destination .....................................................

6. Name of notified railway station/other place, from where delivery is to be taken ...............

7. Number and date of -

a. Railway receipt ....................................

b. Other document ....................................

8. Description of consignment -

Name of goods	value	quantity

9. Seller's invoice/forwarding note number and date ............

10. Mode of transport (vehicle no.) ....................................

I/We hereby declare that the above statements are correct and complete to the best of my/our knowledge and belief.

Signature of dealer/declared manager

Date ........................

RESULT OF CHECKING ON THE ROUTE

Designation and head quarters of the authority by whom transport of consignment was checked.	Description of goods	Quantity of the goods actually transported.	Dated signature of the authority mentioned in column I and place of checking
1	2	3	4

NOTE-(1) Separate form should be used for each consignment.

(2) (a) In case of transport across or beyond check-post, a copy of the form should accompany the consignment.