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The Gujarat Value Added Tax Rules, 2006
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FORM-109

[See rule 18A(3)]

Application for Certificate of Entitlement

Sr. No. Description Details
1. Name of unit  
2. Address  
3. Registration No. under Gujarat Sales Tax Act, 1969.  
4. Registration No. under the Value Added Tax Act, 2003  
5. Number and date of Government Resolution under which Eligibility Certificate was issued by the Industries Department  
6. The amount of incentives granted under Eligibility Certificate.  
7. Period of incentive granted under Eligibility Certificate.  
8. Number and date of Government Resolution under which Exemption Certificate was issued by the Commissioner under the earlier year.  
9. The amount of incentives granted under

Exemption Certificate.

 
10. Period for which incentive granted under Exemption Certificate.  
11. Amount availed upto 31-03-2006:

(i) under the Gujarat Sales Tax Act,1969

(ii) under the Bombay Sales of Motor Spirit Taxation Act, 1958

(iii) under the Central Sales Tax Act, 1956

Total:

 
12. Balance amount available under the Act  
13. Option for remission of deferment of tax (applicable in case of composite benefits)  

I........................................... Do hereby certify that the details shown in the application is true and correct.

Place:  
Date: (Authorised Signatory)