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The West Bengal Sales Tax - Forms
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GOVERNMENT OF WEST BENGAL GOVERNMENT OF WEST BENGAL
FORM 12 FORM 12
Form of Declaration Form of Declaration
(See rule 74, rule 75 and rule 76) (See rule 74, rule 75 and rule 76)
 

Issued to the holder of Registration Certificate No. .......................

 

(Name of the undertaking supplying electrical energy)

COUNTERFOIL

Serial No. ...........

 

To ............................. (Seller)

 

.................................... (Address)

Serial No. .....................

Certified that-

To ................. (Seller)

(a) the goods *ordered for in *my/our purchase order No. .................. dated ..................... /*purchased from you as per *bill/cash memo stated below *supplied under Challan No. ..................... dated .............. are-

...................... (Address)

Declaration given against :-

*(a) Purchase Order No. ................. dated ............................

(i) *for use directly in the manufacture in West Bengal of *taxable goods or newspapers for sale

*(b) Bill/Cash Memo No. .............. dated ......................

(ia) for use directly, in the manufacture in West Bengal of goods other than taxable goods or newspapers, for sale in West Bengal.

*(c) Challan No. ............................ dated ..........................

(ii) *for use directly in connection with raising of coal for sale,

 

(iii) *for use directly in the generation or distribution of electrical energy *wholly in West Bengal/partly in West Bengal and partly outside West Bengal,

 

(iv) containers and other materials for the packing of goods* ordered/purchased/ supplied as referred as above,

Date .......................

(v) *containers and packing materials for use in the packing in West Bengal of *taxable goods, or newspaper imported into West Bengal, or manufactured in West Bengal for sale

 

(vi) Containers and packing materials for use in the packing in West Bengal of goods other than taxable goods or newspapers, manufactured in West Bengal for sale in West Bengal

 

(b) *the goods *ordered/purchased/supplied as referred to in item ........ above are covered by *my/our certificate of registration No. ............ dated ............... /*my/our certificate of registration number .............. is dated .........

 

Bill/Cash Memo .............. No. ...... dated ........... Amount

 

Name of the purchasing dealer/undertaking in full.

 

---------------------- Signature and status of the person signing the declaration

 

Date .................