FORM 10-A
(See rule 23A )
Return verification Form
Name and address of the Dealer
(Affix seal)
Acknowledgment Number
1. Gross turnover (GTO)
2. Deductions
3. Taxable turnover (1-2)
4. Vat
5. Purchase tax
5A. Amount payable u/s 9-C
5B. Amount payable u/s 26-A (5)
6. Reversal of Input Tax Rebate
7. .Interest for fate payment (if any)
8. Amount of tax deferred / exempted
9. Total amount payable (4+5+5A+5B+6+7-8)
10. Input Tax Rebate
11. Input Tax Rebate and other credits carried forward from previous quarter
12. Other credits (TDS, RAO etc.) .
13. Amount paid by challans
14. Unadjusted rebate and other credits carried over to next Quarter (TDS, RAO &
Challan amount) .
Declaration
I ....................................(Name) being .................................... of the above business firm do hereby declare that the information and particulars given in the return which has been transmitted electronically by me vide acknowledgment number mentioned above are true and correct to the best of my knowledge and belief.
Note: This Form shall be signed by any person as prescribed in sub-rule (1) of rule 11 of the Madhya Pradesh Vat Rules. 2006.
For Office Use only
Return Verification Form for the Quarter/ year / month of F.Y. .....................
ACKNOWLEDGMENT
Return Verification Form Receipt Number: .................. Date .../../..