FORM 4A

[See Rule 8-A(1)]

Option for grant of permission to make lump sum payment by way of composition under Section 11-A of the Madhya Pradesh Vat Act, 2002

To,

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

.............................. Circle.

I, ................................ A dealer holding registration certificate No. (TIN)................ Under the Madhya Pradesh Vat Act, 2002, have taken a works contract at ............... (Place) for execution of the work (give description of work) for Rs. ..................... The execution of the contract shall commence on ........... and is likely to be completed by ........... I desire to pay a lump sum amount by way of composition in lieu of tax that would be payable on goods that may be supplied in the execution of the said works contract awarded to me and accordingly, I hereby seek permission to make such lump sum payment under Section 11-A of the Madhya Pradesh Vat Act, 2002.