The Gujarat Value Added Tax Rules, 2006
-

FORM 210C

(See sub-rule (1) of rule 28C)

Application for permission to pay lump sum tax under section 14D of the Gujarat Value Added Tax Act, 2003.

To,

The Commercial Tax Officer

...............................................

I hereby submit my application for grant for permission to me / Ms / ...................................................................... ............................................................... To pay lump sum tax under section 14D of the Gujarat Value Added Tax Act, 2003.

The Details of my business are as under :

1.	Name of the Applicant	: _____________________________
2.	Name of the Firm (Business)	: _____________________________
3.	Address	: _____________________________
		______________________________
		______________________________
4.	Other Places of business	: _____________________________
5.	Registration Number under Gujarat Value Added Tax Act, 2003.	: _____________________________
6.	Registration Number under the Central Sales Tax Act, 1956	: _____________________________
7.	Nature of Business	: _____________________________
8.	Name of the major commodities dealt with	: _____________________________

I may be granted permission to pay lump sum tax for the period commencing from ______________ and ending on the 31st March, _____________.

Place : _______________	Signature : _______________
Date : _______________	Designation : _______________