FORM 4

[See Rule 8(2)]

Option for composition under section 11 (1)of the Madhya Pradesh Vat Act, 2002.

To,

The ...................... (designation).

______________Circle

(1) I, __________ (Name of the dealer) ______________ (Address) holding
TIN ___________ under the Madhya Pradesh Vat Act, 2002 hereby give the option for payment of a lump-sum in lieu of tax by way of composition for the year ____________. For that purpose I hereby declare that I am dealing in goods declared tax free under section 16 or/and goods being purchased by me from other registered dealers after payment to them of tax under section 9 of the said Act and/or goods manufactured by me using goods exempted under section 16 or/and purchased from other registered dealers after payment of tax under section 9 of the said Act.

(2) That my turnover in a year has ordinarily been less than rupees .one crore

(3) I shall furnish returns for the period specified in sub-rule (6) of rule 8 of the Madhya Pradesh Vat Rules, 2006 from the date on which the option given by me stands revoked under the provisions of sub-section (2) of section 11 of the said Act.

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ACKNOWLEDGMENT