The Gujarat Value Added Tax Rules, 2006
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(Appended to Form 101)

FORM 101D

(See rule 5)

Affix Passport size photo of Partner / Director / Responsible Person

DETAILS OF PARTNERS/DIRECTORS/PERSONS RESPONSIBLE

1.	Full Name
2.	Father's/Husband's Name
3.	Date of Birth
4.	Extent of interest in business (Partnership firm)/ Official Designation and date of joining in the present capacity (in case of Directors in Limited Companies)/Status & function of Person Responsible (Authorised) for the business.
5.	Other business interests in the State (please specify)
6.	Other business interests outside the State (Pl. specify)
7.	Present Residential Address: Telephone No: e-mail:
8.	Permanent Address: Telephone No.
9	Income Tax Permanent Account Number (PAN)

Date:
	Signature & Status.