FORM 61

[See rule 78 (1)]

Information under section 62(1) of the Madhya Pradesh Vat Act, 2002.

To,

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

___________________ Circle

I, _______________ Proprietor/*Manager/*Director of proprietorship concern /* firm /*society*/ company known as ________________________ whose office is situated at (address) ____________________________________ hereby inform that I am carrying on the business of clearing, forwarding, booking agent /* broker/* transporting of goods under the aforesaid name within jurisdiction of your circle.

* strike out whichever is not applicable.

_______________________________________________________________________________________

ACKNOWLEDGMENT

Received an intimation in form 61 from shri ____________________________ of ________________________ (name of the business ) ___________ place on _____________.

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