DEMO|

THE KARNATAKA GOODS AND SERVICES TAX FORMS 2017
INPUT TAX CREDIT

Form GST ITC-04

[See Rule - 45(3)]

Details of goods/capital goods sent to job worker and received back

1. GSTIN -  
2. (a) Legal name -  
  (b) Trade name, if any -  
3. Period: Quarter- Year-

4. Details of inputs/capital goods sent for job-work

GSTIN / State in case of unregistereed jobworker

Challa n no. Challan date Description of Goods UQC Quantity Taxable value Type of goods (Inputs /capital goods) Rate of tax (%)
Central Tax State Tax Integrated Tax Cess
1 2 3 4 5 6 7 8 9 10 11 12
                       
                       

5. Details of inputs/capital goods received back from job worker or sent out from business place of job-work

GSTIN / State of job worker if unregistered

Received back/sent out to another job worker/ supplied from premises of job worker Original challan No. Original challan date Challan details if sent to another job worker Invoice details in case supplied from premises of job worker Description UQC Quantity Taxable value
No. Date GSTIN/ State if job worker unregistered No. Date
1 2 3 4 5 6 7 8 9 10 11 12 13
                         
                         

6. Verification (by authorized signatory)

I hereby solemnly affirm and declare that the information given herein above is true and correct to the best of my knowledge and belief and nothing has been concealed therefrom.

  Signature
   
Place Name of Authorized Signatory..............
Date Designation /Status.........................