The Kerala General Sales Tax - Forms
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THE KERALA GENERAL SALES TAX RULES, 1963

FORM 1C

FORM OF APPLICATION FOR CERTIFICATE UNDER SUB SECTION 3A OF SECTION 14

[See Rule 5(29) (i)]

To,

The Assessing Authority

I................................................................... Son of ........................................................... on behalf of the dealer carrying in the business whose particulars are given below, hereby apply for a certificate under sub-section 3A of Section 14 of the Kerala General Sales Tax Act, 1963.

1.	Name and Postal Address of the dealer (if there is trade name, the trade name shall also be given)	:
2.	Details of Registration No. under the KGST/CST Act.	:
3.	Name and full address and status of the person who signs the application (as regards, status, specify whether Proprietor, manager, Director, Partner, Etc.)	:
4.	The place where the exhibitions, exchange melas or any prize scheme with full particulars.	:
5.	Period of duration of the exhibitions, exchange melas or any prize scheme with full particulars.	:
6.	Date of commencement	:
7.	Amount of fee paid with particulars of challan No. and date, cheque No. and date, name of treasury/bank etc.	:

DECLARATION

I................................................................................ Son of ........................................................................ hereby declare that to the best of my knowledge and belief the information contained in the application given above are true and correct.

Place :	Name, address and signature of the person signing with status.
Date :

For the official use by the Assessing Authority

1.	Date of Receipt of Application	:
2.	Nature of order passed by the Assessing Authority in the application	:
3.	Certificate No. and date	:
4.	Date of issue of certificate	:

			Signature of the Assessing Authority with date