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THE RAJASTHAN VALUE ADDED TAX RULES, 2006 - FORMS
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Form VAT-01A Omitted w.e.f. 14-07-2014

[See Rule 12A(1)]

Application for e-Registration

To,

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1

Name of Dealer  
Whether Non Resident Dealer Yes/No

2

Address of Principal place of Business
1 Bldg. No. / Name / Area  
2 Town / City  
3 District (State)  
4 Pin Code  
5 E-mail Id  
6 Telephone Numbers (if any)  
7 FAX No. (if any)  

3

Permanent Account Number of business (PAN). (in case of Sole proprietorship, PAN allotted to proprietor be mentioned)  

4

Date of Commencement of business  

5

Date from which liable to be registered  

6

Type of Dealer VAT / u/s 3(2) / u/s 5 (1)

7

Nature of Business Manufacturer / Retailer / Leasing / Wholesaler / Works Contractor / Exporter / Other, please specify

8

Commodities dealt with/ proposed to be dealt with Intended to purchase
Intended to sale

9

Constitution of Business proprietorship /partnership / / Private Ltd. Company / Public Ltd. Company / Public Section undertaking / HUF / Co-operative Society /Club / Trust / Central/State Government Department / Others, please specify

10

Particulars of proprietor /partners /directors / Karta /Trustees/Members of the governing body / authorized signatory:
(i) Full Name  
(ii) Father's / Husband's Name  
(iii) Date of Birth  
(iv) Status  
(v) Extent of interest %  
(vi) Permanent address  
(vii) Telephone No. (if any)  
(viii) PAN (if any)  
(ix) E-mail ID (if any)  
(x) Details (including address) of all immovable property owned by or in which the person has interest/ joint interest  
(xi) Particulars of interest in any other business (es), if any.
a. Name of other business  
b. Complete address of other business  
c. TIN  
d. CST No.  
e. Nature of interest in the business  
f. Extent of interest  
(xii) Particulars of interest in any other closed business (es)
a. Name of closed business  
b. Complete address of closed business  
c. R. C. No.  
d. Date of Closure  
e. Nature of interest in the business  
f. Extent of interest  

11

Details of Surety/Security Bond:
A In case of surety  
I Name of business of I surety  
  TIN  
II Name of business of II surety  
  TIN  
B In case of security is furnished by cash / NSC, details thereof
S. No. Amount No. Date of Maturity
1      
2      
3      
 
C In case of security is furnished by Bank Guarantee, details thereof
1 Amount of Bank Guarantee  
2 Effective period of Bank Guarantee  
3 Name of Bank and address of Branch  

12

Information regarding Bank Account
1 Name of Bank  
2 Name and address of Branch  
3 Account No.  
4 IFSC Code of Branch  

13

Details of Branch(es) / Additional Place(s) of business including warehouse(s) in the State:
  Factory Godown / Warehouse Branch(es) / Additional Place(s) Others (please specify)
1 Bldg No./ Name / Area        
2 Town /city        
3 District (State)        
4 Pin Code        
5 E-mail Id (if any)        
6 Telephone Number(s) (if any)        
7 FAX No. (if any)        
 

14

Details of Branch(es) Additional Place(s) of business outside the State:
1 Bldg No./ Name / Area  
2 Town /city  
3 District (State)  
4 Pin Code  
5 E-mail Id (if any)  
6 Telephone Number(s) (if any)  
7 FAX No. (if any)  

15

Details of business manager(s)  
1 Name of Business Manager  
1 Bldg No./ Name / Area  
2 Town /city  
3 District (State)  
4 Pin Code  
5 E-mail Id (if any)  
6 Telephone Number(s) (if any)  
7 FAX No. (if any)  
To be furnished by a dealer opting for registration under the CST Act, 1956

16

Type of Registration U/s 7(1) / u/s 7(2)

17

Goods or class of goods to be purchased in the course of Inter state trade or commerce for resale
Use of manufacture or processing of goods for sale
Use in mining
Use in generation or distribution of electricity or any other form of power
Use in the packing of goods for sale/resale