MADHYA PRADESH VALUE ADDED TAX RULES, 2006 - FORMS
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Body

FORM 65-A

(See rule 81-A)

Option under clause (a) of Section 55-A of the Madhya Pradesh VAT Act, 2002

To,

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I ...................................... (Name of the dealer) .......................................... (address) holding TIN ................. (if any) under the Madhya Pradesh Vat Act, 2002 hereby give the option for payment of lump sum in respect of the amount of evasion of tax agreed to by me at the time of requisition * or inspection under clause (a) of section 55-A of said Act of Rs...............................................(in figures) Rs................................................... (in words) for the block period from ..............................................to............................ The lump sum amount of Rs...................................(in figures) Rs.................................. (in words) has been paid vide challan No. ..........................dated........................... Which is enclosed.

2. I undertake that I shall not challange the amount of evasion of tax agreed to by me in any forum

Place .......................................
Date .......................................	Signature of the dealer ...............................

* Strike out whichever is not applicable