Maharashtra Value Added Tax Rules, 2005 FORMS
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Fee Rs. 100/-

Sr. No.

APPLICATION FORM FOR GRANT OF FRESH CERTIFICATE OF REGISTRATION AND ALLOTMENT OF TAXPAYER IDENTIFICATION NUMBER (TIN)

(Please read the instructions carefully before filling the application form)

INSTRUCTIONS

1.	The application form must be filled in English bold letters and numerals.
2.	Application for TIN will not be accepted if the same is not complete in all respects.
3.	A black ball point pen should be used to fill in the form.
4.	No field should be left blank. If the field is not applicable dealer should write N. A.
5.	Wherever boxes are provided, only one letter should be written in each box, one box should be left blank between two words.
6.	Wherever the space provided for a particular field is not sufficient, the dealer should photocopy the relevant page, fill-in the required information and attach along with the application.
7.	In the commodities fields (Sr. no. 9 and 10), the dealer must write the name of the top 5 commodities dealt in. The description of the commodities should be specific and not of general nature. However, in case of departmental stores / kirana merchants / general stores etc., the dealer should write 'FMGG' / 'Kirana'.
8.	In serial no 12, 13 and 14, series number of declarations must be written. This number is written before the serial number. For example in declaration form number MAH/01/1656543, the series number is MAH01 and serial number is 1656543.Please do not write the symbol slash [ / ] while filling up the items 12,13 and 14.
9.	In case the dealer is holding more than one R.C., then for his additional place (s) of business, he has to apply for TIN to the officer in charge of principal place of business. He must submit all the original RCs including RCs for additional place (s) of business to that officer. The dealer will be issued a unique TIN for all place (s) of business in Maharashtra.
10.	In case of dealer holding the certificate of entitlement for his backward area unit & also holding R.C. for non-backward area unit, the application for TIN must be submitted at the office in-charge of principal place of business. The certificate of entitlement should not be surrendered, along with the application of TIN.
11.	All the original Registration Certificates under the MVAT Act and the CST Act must be submitted along with the application.
12.	Unutilized statutory declarations / certificates under the C.S.T. Act must be surrendered along with the application.

Acknowledgement

Received an application from the applicant mentioned below for allotment of TIN under section 17(2) of the Maharashtra Value Added Tax Act, 2002.

Serial No in the register

Name of the Dealer

MVAT RC No.

Date of receipt of application

Receiving Officer's

Signature __________________________________________

Name _____________________________________________

Designation & Stamp _________________________________

Telephone No. ______________________________________

Sr. No.

FORM - 108

(See rule 8A)

Application for grant of Fresh Registration Certificate and allotment of Taxpayers Identification Number (TIN) under section 17(2) of The Maharashtra Value Added Tax Act, 2002

(No slash or dash to be written)

MVAT R.C. No

C.S.T. R.C. No.

Date of effect of CST RC (DD/MM/YYYY)

P.T. R.C. No.

Luxury Tax R.C. No.

Sugar Cane Purchase Tax RC No.

Entry of Goods into local area Act R.C. No.

Income Tax Permanent Account Number (PAN) of the business

I hereby apply for grant of fresh certificate of registration under section 17(2) of The Maharashtra Value Added Tax Act, 2002.

1) Name of the Business (in block letters) (keep one box blank between two words)

2) Full address of the principal place of business

Bldg. Name / Office No./ Flat No.

Area Name etc.

Street Name etc.

Village/Town/City

Taluka

District

Pincode

3) Contact details (with STD code)

Telephone (Office) No. 1

Telephone (Office) No. 2

Telephone (Residence)

Fax No.

Mobile No. 1

Mobile No. 2

E-mail address

4) Full address of the additional place(s) of business / Godown(s) / Warehouse(s) in Maharashtra (If space is insufficient please take photocopy of this page and attach)

a) First additional place of business

Building Name / Office No./ Flat No.

Area Name etc.

Street Name etc.

Village/Town/City

Taluka

District

Pincode

VAT R.C. No. (if any)

R.C. No under other Act(s) (if any)

b) Second additional place of business

Building Name / Office No./ Flat No.

Area Name etc.

Street Name etc.

Village/Town/City

Taluka

District

Pincode

VAT R.C. No. (if any)

R.C. No under other Act(s) (if any)

c) Third additional place of business

Building Name / Office No./ Flat No.

Area Name etc.

Street Name etc.

Village/Town/City

Taluka

District

Pincode

VAT R.C. No. (if any)

R.C. No under other Act(s) (if any)

5) Constitution (Please tick the appropriate box)

Proprietor

Partnership

Private Ltd. Co.

Public Ltd. Co.

HUF

Cooperative Society

Public Trust

Others (Please specify)

6) Principal nature of business (Please tick the most appropriate box only )

Manufacturer

Importer

Reseller

Others (Please specify)

7) Nature of business (Please tick the appropriate box(es))

Manufacturer

Wholesaler

Retailer

Importer

Exporter

Works Contractor

Restaurant

Leasing

Commission Agent

Other (Please specify)

8) Have you opted for composition scheme ? (If yes, please tick the appropriate box(es) (Please refer leaflet No. MVAT 106 for eligibility & details of Composition Scheme)

Retailer

Restaurant / Caterer

Bakery

Second Hand Car Dealer

9) Main commodities sold

Sr. No.	Name of the commodity	Schedule Entry	HSN classification (To be filled by the departmental authorities)
1
2
3
4
5

10) Main commodities purchased

Sr. No.	Name of the commodity	Schedule Entry	HSN classification (To be filled by the departmental authorities)
1
2
3
4
5

11) Address(s) in other state(s) and corresponding TIN under C.S.T. Act (If space is insufficient please take photocopy of this page and attach)

a) Address in first State

Bldg. Name / Office No./ Flat No.

Area Name etc.

Street Name etc.

City

State

Pincode

Corresponding CST RC / TIN

b) Address in Second State

Bldg. Name / Office No./ Flat No.

Area Name etc.

Street Name etc.

City

State

Pincode

Corresponding CST RC / TIN

c) Address in Third State

Bldg. Name / Office No./ Flat No.

Area Name etc.

Street Name etc.

City

State

Pincode

Corresponding CST RC / TIN

d) Address in Fourth State

Bldg. Name / Office No./ Flat No.

Area Name etc.

Street Name etc.

City

State

Pincode

Corresponding CST RC / TIN

12) Details of declarations under CST Act, last issued by the department to the dealer

(If space is insufficient please take photocopy of this page and attach)

Declaration Type

Series No.

Serial No.

Total No's. issued

Total No's. utilised

Balance No. of forms surrendered

From

13) Details of unused declarations under CST Act, surrendered (if necessary, separate sheet may be attached)

Declaration Type

Series No.

Serial No.

Total No. of forms surrendered

From

14) Utilization details of Statutory Declarations under CST Act.

(Details to be given in respect of forms last issued by the department)

If space is insufficient please take photocopy of this page and attach)

Sr. No.	Type of Declaration / Certificate	Financial year for which declaration is used	Series No. of the declaration / Certificate	Serial No. of the Declaration / Certificate	Name of the Selling Dealer / Branch / Agent	CST RC / CST TIN of the selling dealer / Branch / Agent	Description of the goods covered by the declaration	Total number of invoices covered by the declaration	Total Value of goods for all invoices covered by the Declaration (Rs.)
1	2	3	4	5	6	7	8	9	10

15) Tax Payment history of last three years (Amount in Rs.)

Act

Details of

Year

2002-03

2003-04

2004-05

BST

Turnover of sales

Tax Paid

Refund

CST

Turnover of sales

Tax Paid

Refund

WCT

Turnover of sales

Tax Paid

Refund

Lease Tax

Turnover of sales

Tax Paid

Refund

Luxury Tax

Turnover of sales

Tax Paid

Refund

Motor Spirit Tax

Turnover

Tax Paid

Refund

Entry Tax on goods

Turnover of sales

Tax Paid

Refund

SCPT

Turnover of purchases

Tax Paid

Refund

16) Details of Proprietor / Partner / Director / Members of Managing Committee / all person having any interest in the business (including the members of Hindu Undivided Family Business). Not to be filled in if the applicant is a Department of Government. (If space is insufficient please take photocopy of this page and attach)

Sr. No.

Full Name of Proprietor / Partner / Director / Members of Managing Committee / all persons having any interest in the business. Please include father's name and surname

Permanent Residential Address

Name and RC Nos. of all other business within the State, in which the person has any share of interest

IT PAN

Profession Tax EC No.

Building Name / Office No. / Flat No.

Area Name etc.

Street Name etc.

Village / Town / City

Taluka

District

PIN Code

Building Name / Office No. / Flat No.

Area Name etc.

Street Name etc.

Village / Town / City

Taluka

District

PIN Code

Building Name / Office No. / Flat No.

Area Name etc.

Street Name etc.

Village / Town / City

Taluka

District

PIN Code

17) Details of Bank Account (s)

Name of the Bank

Branch

Account Number

Name of the Bank

Branch

Account Number

Name of the Bank

Branch

Account Number

18) Whether the records are computerized ? (Please tick the appropriate box)

Yes

Partially

19) Details of Entitlement Certificates under Package Scheme of Incentives

Sr. No.	EC No.	Scheme	Mode (Deferral / Exemption)	Location of Unit

The abvoe information is true to the best of my knowledge and belief.

Place -

Date -


	Seal of the firm

Name & Signature of applicant, Status and authority thereof

___________________________________________________________________________________________

FOR OFFICE USE ONLY

Serial No of receipt register

Date of Application

Application accepted by (signature)

Name and designation

Application Verified by (signature)

Name and designation

Data entry validation done by (signature)

Name and designation

Details of TIN

Issue Date -