FORM 404

[See sub rule (1) of rule 52]

Application for issue of Transit Pass under sub-section (1) of section 69 of the Gujarat Value Added Tax Act, 2003.

ORIGINAL

DUPLICATE

TRIPLICATE

To,

The Officer in charge

______________ Check post or barrier

Sir,

1. I _____________________________ son of Shri__________________ resident of _________________________________________________________ (full Address) hereby declare that I am the owner or driver of vehicle/truck No.__________ belonging to ________________________________________________________________________________________

________________________________________________________________________________________

__________________________________________________

(name and address of the owner or transporting agency)

2. I hereby declare that the consignment mentioned in the Annexure annexed hereto being carried by the above-mentioned vehicle is meant for destination to the other State. It will not be unloaded or delivered any where in the State of Gujarat.

3. I may be issued a transit pass for the said purpose.

4. My vehicle/truck will cross the Gujarat State and enter into _____________________ State boarder at Check Post/barrier on or before____________Date_______________ by___________hours(time).