Andhra Pradesh Value Added Tax Rules, 2005- Forms
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Body

FORM VAT 501-H

(See Rule 17D(i))

Declaration and Undertaking

Declaration to be issued by the dealer for tax on the sales of Furnace Oil to coastal ships under Section 4A(b) of the Andhra Pradesh Value Added Tax Act, 2005.

This is to certify that I/We ___________________________ (Name and full address of the dealer with TIN) have sold the following goods as per the details mentioned below:

Sl. No	Name and address of the purchaser	Invoice No. & Date	Marine delivery receipt No./ Bunker Delivery Note No. and Date	Name of the Coastal Ship	Name of the shipping agent	Descri-ption of the goods sold	Sale value	VAT amount payable
(1)	(2)	(3)	(4)	(5)	(6)	(7)	(8)	(9)

I/We hereby declare that the sales of the above mentioned goods are eligible for tax @ 5% under section 4A(b) of the Andhra Pradesh Value Added Tax Act, 2005. In the event of finding that the above information is false, I/We hereby undertake to pay to the Government the differential tax amount without prejudice to the penal action taken against us.

Place:	Signature:
Date:	Name & Address:
	Seal.