FORM 33

[See rule 45(5)(a)]

Application for grant of a certificate under section 27 of the Madhya Pradesh Vat Act, 2002

To,

The ...................... (designation),

(Circle),

I, __________________ (Name) of ______________________ (Name of the business, status therein) ______________________________ (Address) holding TIN________________ under the Madhya Pradesh Vat Act, 2002 request for grant of certificate under section 27 of the said Act, to be issued to the authorized officer purchasing goods on behalf of the Central / * State Government __________________________________________ (Name, designation and address) or to the person letting out a Works contract __________________________________________ (Name and address)

Detais are given below:-

1) Description of goods _______________________________________________

2) Date on which/period within which to be supplied ____________________________

3) Purchase order/Contract No. and date _________________________________

4) Value of the purchase order/contract __________________________________

(5) Estimated value of likely sale or purchase taking place outside the State of Madhya Pradesh or in the Course of inter-State trade or commerce or in the course of import of goods into the territory of India (if any) ..........................

(6) Estimated value of Labour (if any) ..........................................

(7) Reason for making deduction at Zero rate */ lower rate ..........................

I hereby declare that the particulars given above are true to the best of my knowledge and behalf.

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