THE WEST BENGAL VALUE ADDED TAX RULES, 2005 : FORMS
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THE WEST BENGAL VALUE ADDED TAX RULES, 2005

FORM - 1CR

Application for Composition Registration

[See sub rule (1) of rule 5]

[please see Instructions before filing up the Application

Self attested

photograph of

the signatory

01. Name of the Applicant in BLOCK LETTERS

First name

Middle name

Surname

02. Sex (Male/Female)

03. Father's Name / Husband's Name [in BLOCK LETTERS]:

First name

Middle name

Surname

04. Trade Name [in BLOCK LETTERS]:

05. Address of the Principal place of business [in BLOCK LETTERS]:

Room/Flat No.

Premises No. & Street

City/Town

District

Pin Code

06. (i) Mobile no. (Mandatory)

(ii) e-mail id

07. Bank Account details [in BLOCK LETTERS]:

Bank Name	Branch	A/c No.	Type of A/c	IFS Code

08. Occupancy Status:
09. Status of the business:
10. If partnership, number of partners:

11. Nature of goods resold [in BLOCK LETTERS]:

12. Contact details of Proprietor / Partners / Karta etc. [in BLOCK LETTERS] :

Name
Residential address
PAN
Phone
Name
Residential address
PAN
Phone

13. Turnover of sales (Gross) of previous year :

Rs.

14. Details of amount paid in terms of rule 38(3 A):

Amount	Challan No.	Payment Date	Bank	Branch Name

I, ............................................................................................................................................................, do hereby

declare that I opt to pay fixed amount under sub-section (3) of section 16 and that the above information are true to the best of my knowledge and belief.

Date...........................	Signature..............................................................
	Status.................................................................... Proprietor/Partner/Karta)

* Please use separate sheet wherever space is inadequate.

If submitted through VAT Return Preparer
Name of Vat Return Preparer [in BLOCK LETTERS] :
VRPNo.
Signature of Vat Return Preparer
Date [DDMMYYYY]

Information for filling up the application form for registration.

(A) Fill in the boxes with the appropriate code (given below) that identifies the occupancy status:
Owned-01	Rented - 02	Leased - 03	Rent-free - 04	Others - 05
(B) Please enter the two digit code that identifies the status of the business from the selection below :
Proprietary-01	Unregistered Partnership-02	Registered Partnership-03	Hindu Undivided Family-04	Others-12

(C) Documents to be submitted with the application for composition registration in Form 1CR
Self attested photo copy of ANY ONE of the following as proof of identity of the applicant	Self attested photo copy of ANY ONE of the following as proof of occupancy of the place of business:	Self attested photo copy of ANY ONE of the following as proof ofresidence of the signatory:
i. PAN Card;	i. Trade License;	i. Telephone bill;
ii. Voter's ID Card;	ii. Telephone bill;	ii. Electric bill;
iii. Driving Licence;	iii. Electric bill;	iii. Property Tax Receipt/Rent ;Receipt
iv. Aadhar Card.	iv. Rent Receipt;	iv Bank passbook;
	v. Certificate from Councillor of Municipal Corporation/ Ward Commissioner of Municipality / Panchayat Pradhan/ MLA/ MP	v. Driving Licence:
	vi. Bank pass book * [format of the certificate available at the Directorate's website www.wbcomtax.gov. in]	vi Aadhar Card

Receipt

Received Application in Form - 1CR from
Date	Receipt SI. No.	Office Seal	Signature