THE RAJASTHAN VALUE ADDED TAX RULES, 2006 - FORMS
-

Body

Form VAT-69

(See Rule 17A)

Application for permission to pay tax in lump sum

To,

The Assessing Authority

________________________

I submit my application as follows for the grant of permission to pay tax in lump sum under rule 17A of Rajasthan Value Added Tax Rules, 2006 for the period commencing from _____________ .

The Details of my business are as under :

1	TIN
2	Name of the Applicant :
3	Name of the Dealer :
4	Address :
5	Commodities for which option to pay tax in lump sum is opted:
6	If opting under sub rule (2) of the rule 17A:
	a. Turnover of Current Financial Year upto the date of application:
	b. Tax charged or collected (if any):
	c. Composition Amount which has become due:
	d. Interest payable on the Composition Amount due:
	e. Late fee payable:
	f. Date of deposit of due Amount:
7	Closing stock which has suffered tax in the State (as on date of application) :
8	Amount of ITC to be reversed on closing Stock as mentioned at S.No. 7:
9	Closing stock which has not suffered tax in the State:
10	Date of deposit of tax on closing stock as mentioned at S.No. 9:

I/We declare that the information given above is true and correct to the best of my/our knowledge and nothing has been concealed and I shall abide by all the conditions specified in relevent rule.

Place :	Signature
Date :	Designation: