THE HARYANA VALUE ADDED TAX - FORMS
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Body

Form VAT-D2A

[Declaration of SEZ dealer making purchase of goods at zero rate of tax]

(Part A)

(To be furnished to the assessing authority by the selling dealer)

[See rule 21A]

Serial No.:	_____________________
Office of Issue:	_____________________
Date of Issue:	_____________________
Detail of the SEZ dealer
(a) Name:	_____________________
(b) Place of Business:	_____________________
(c) District:	_____________________
(d) TIN:	_____________________
(e) Registration No. Issued by the Development Commissioner, SEZ:	_____________________
(f) Date from which Registration Certificate is valid:	_____________________
(g) Address of the Development Commissioner, SEZ issuing the Registration No.	_____________________

Seal of the issuing Authority or Authenticating Authority.

Name and address of the Selling dealer ________________________ ___________________________________ TIN __________________

Certified that the goods supplied by you as per the following invoices are goods of the class or classes specified in the certificate of registration held by me/us and have been purchased for the purposes specified under sub-section (6) of section 7 of the Haryana Value Added Tax Act, 2003.

Serial Number	Invoice Number & Date	Description of goods	Value of Goods

The above statements are true to the best of my knowledge and belief and nothing has been concealed therefrom.

Signature with date:	______________________
Name of the person signing the declaration on behalf of the SEZ dealer:	______________________
Status of the person signing the declaration in relation to the SEZ dealer:	_____________________

Form VAT-D2A

[Declaration of SEZ dealer making purchase of goods at zero rate of tax]

(Part B)

(To be retained by the purchasing dealer)

[See Rule 21A]

Serial No.:	_____________________
Office of Issue:	_____________________
Date of Issue:	_____________________
Detail of the SEZ dealer
(a) Name:	_____________________
(b) Place of Business:	_____________________
(c) District:	_____________________
(d) TIN:	_____________________
(e) Registration No. Issued by the Development Commissioner, SEZ:	_____________________
(f) Date from which Registration Certificate is valid:	_____________________
(g) Address of the Development Commissioner, SEZ issuing the Registration No.	_____________________

Seal of the issuing Authority or Authenticating Authority.

Name and address of the Selling dealer ________________________ ___________________________________ TIN __________________

Serial Number	Invoice Number & Date	Description of goods	Value of Goods

The above statements are true to the best of my knowledge and belief and nothing has been concealed therefrom.

Signature with date:	______________________
Name of the person signing the declaration on behalf of the SEZ dealer:	______________________
Status of the person signing the declaration in relation to the SEZ dealer:	_____________________

Form VAT-D2A

[Declaration of SEZ dealer making purchase of goods at zero rate of tax]

(Part C)

(To be retained by the selling dealer)

[See Rule 21A]

Serial No.:	_____________________
Office of Issue:	_____________________
Date of Issue:	_____________________
Detail of the SEZ dealer
(a) Name:	_____________________
(b) Place of Business:	_____________________
(c) District:	_____________________
(d) TIN:	_____________________
(e) Registration No. Issued by the Development Commissioner, SEZ:	_____________________
(f) Date from which Registration Certificate is valid:	_____________________
(g) Address of the Development Commissioner, SEZ issuing the Registration No.	_____________________

Seal of the issuing Authority or Authenticating Authority.

Name and address of the Selling dealer ________________________ ___________________________________ TIN __________________

Serial Number	Invoice Number & Date	Description of goods	Value of Goods

The above statements are true to the best of my knowledge and belief and nothing has been concealed therefrom.

Signature with date:	______________________
Name of the person signing the declaration on behalf of the SEZ dealer:	______________________
Status of the person signing the declaration in relation to the SEZ dealer:	_____________________