THE RAJASTHAN VALUE ADDED TAX RULES, 2006 - FORMS
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Form VAT- 05

[See Rule 16(1)]

Application for Amendment in the Registration Certificate

Registration No. (TIN)

Name of Dealer

Change in Name of Dealer

Date of change

New Name of Dealer

Change in Principal Place of Business

Date of change

New Address of Principal Place of Business

Bldg. No/ Name/ Area

Town/City

District (State)

Pin Code

Email Id

Telephone Number(s)

Fax No.

New Additional Place(s) of Business

Date of change

Type

Factory

Godown

Branch

Others

New Address of Pricipal Place of Business

Bldg. No/ Name/ Area

Town/City

District (State)

Pin Code

Email Id

Telephone Number(s)

Fax No.

Change in goods dealt with Intend to Purchase

Date of change

Additions :

	Intend to Purchase	Intend to sale
	1._________________Code*_____	1._________________Code_____
	2._________________Code_____	2._________________Code_____
	3._________________Code_____	3._________________Code_____
	4._________________Code_____	4._________________Code_____
	.......................................................	.......................................................

Deletions :

	1._________________Code*_____	1._________________Code_____
	2._________________Code_____	2._________________Code_____
	3._________________Code_____	3._________________Code_____
	4._________________Code_____	4._________________Code_____
	.......................................................	.......................................................

Closure of Additional Place(s) of Business

Date of change

Type

Factory

Godown

Branch

Others

If other, please specify ______________________________

New Address of Pricipal Place of Business

Bldg. No/ Name/ Area

Town/City

District (State)

Pin Code

Email Id

Telephone Number(s)

Fax No.

Acquisition/amalgamation of Business

Date

Name of Dealer

Nature of Business

Manufacturer

Retailer

Leasing

Wholesaler

Works Contractor

Exporter

Others, please specify

___________________________

TIN of seller

Address

Bldg. No/ Name/ Area

Town/City

District (State)

Pin Code

Email Id

Telephone Number(s)

Fax No.

Sale of disposal of Business in part

Date of disposal

Name of Dealer

Nature of Business

Manufacturer

Retailer

Leasing

Wholesaler

Works Contractor

Exporter

Others, please specify

___________________________

TIN of seller

Address

Bldg. No/ Name/ Area

Town/City

District (State)

Pin Code

Email Id

Telephone Number(s)

Fax No.

Change Nature of Business

Date of change

Manufacturer

Retailer

Leasing

Wholesaler

Works Contractor

Exporter

Others, please specify

___________________________

10. Details of outgoing & incoming partners / directors / Karta / Trustees / Members of the governing body/ authorised signatory:

Incoming

Outgoing

11. Change in particulars of the proprietor / partners / directors / Karta / Trustees / Members of the governing body/ authorised signatory, and particulars of incoming partners / directors / Karta / Trustees / Members of the governing body/ authorised signatory

(A) Particulars-

1. Full Name

2. Father' / Husband's Name

3. Age

4. Status

5. extent of interest %

6. Permanent address

7.Telephone No.

8. PAN (if any)

9. Details (including address) of all immovable property owned by or in which the person has interest/ joint interest

10. Name & Address of witness

Signature

Signature of witness

(B) Particulars of changes in interest in any other business (es)

1. Name of other business

2. Complete Address of other business

3. R.C. No.

4. CST NO.

5. Nature of interest in the business

6. extent of interest

5. Nature of interest in the business

6. extent of interest

12. Change in surety

Name and RC No. (TIN) of existing surety which is withdrawn

Name and RC No. of new surety given

13. Change in Bank Details

Name of Bank & Branch (Closed A/c)

Account No. (Closed A/c)

Name of Bank & Branch (New A/c)

Account No. (New A/c)

14. Any other change(s)

_____________________________________________________________________________________________

Place :		Name :		Signature
Date :		Status :

Verification

I certify that the above information and its attachments (if any) is true and correct to the best of my knowledge and belief and nothing has been concealed.

Place :		Name of Applicant (s)		Signature
Date :		Status with Seal

Instructions:

1. Please read the instructions carefully

2. All the entries should be filled in capital letters

3. "Tick" applicable in option boxes

4. The application should be filed in duplicate.

5. This Form should be verified and signed by.

a. Proprietor, in case of Proprietorship concern.

b. Managing Partner, in case of Partnership firm and where there is no Managing Partner, by all the partners if there is no registered partnership deed and in case of a registered partnership deed by any one of them.

c. Managing Director or authorized signatory, in case of a Company.

d. Karta, in case of Hindu Undivided Family.

e. Authorised Signatory, in all other cases

6. Enclose supporting documents.

7. Enclose orginal copy of Registratiion Certificate which is required to be amended.