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

FORM NO. 9B

See Rule 21 (7D)(2)

Return for draws in lottery tickets for the month ..............................

(To be filled by the Assessing Authority)					(To be filled by the assessee)
Date of filling .................................					Register No.................................
No. enclosures ..............................					Assessment year ........................
					Circle ...........................................

1.	Name and address of the dealer with status (Specify whether Proprietor, Partner, Manager, Director etc.)			:
2.	Trade name (if any)			:
3.	Total No. of draws			:
	(i)	Name of the State Government(s)/person conducting the lottery		:
	(ii)	Name of the authorized distributor or sole selling agent or the Government/person conducting the lottery		:
	(iii)	Name of the all India authorized distributor and name of the first Distributor/Agent in Kerala who is paying tax.		:
	(iv)	Name of the lottery		:
	(v)	Number of draws in a month		Draw number		Total no. of draws
		(i)	Weekly lotteries
		(ii)	Bi-weekly lotteries
		(iii)	Monthly lotteries
		(iv)	Bumper/Super/Festival lotteries
		(v)	Mega/Bumper Lotteries
	(vi)	Date and draw of lotteries		Draw number		Date and day of draw
		(i)	Weekly lotteries
		(ii)	Bi-weekly lotteries
		(iii)	Monthly lotteries
		(iv)	Bumper/Super/Festival lotteries
		(v)	Mega/Bumper Lotteries
	(vii)	Tax due and paid		No. of draws in a month		Rate/draw	Tax due
		(i)	Weekly lotteries		"	"	"
		(ii)	Bi-weekly lotteries		"	"	"
		(iii)	Monthly lotteries		"	"	"
		(iv)	Bumper/Super/Festival lotteries		"	"	"
		(v)	Mega/Bumper Lotteries		"	"	"
		(viii)	Tax paid Rs.
		(ix)	Mode of payment with details	:
		(x)	Amount adjusted with reasons	:

DECLARATION

I ................................................................... son of ...................................................... do hereby solemnly declared that to the best of my knowledge and belief, the information furnished in the return and the statement and documents accompanying it relevant to the month are correct, complete, and truly stated and in accordance with the provision of the Kerala General Sales Tax Act, 1963 and the Kerala General Sales Tax Rules, 1963.

Place :	Signature and Name of the dealer status in relation to business.
Date :