The West Bengal Sales Tax - Forms
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GOVERNMENT OF WEST BENGAL		GOVERNMENT OF WEST BENGAL
FORM 13		FORM 13
Form of Declaration		Form of Declaration
To be issued by the selling dealer		To be issued by the selling dealer
(See rule 77 (1) and rule 84)		(See rule 77 (1) and rule 84)
COUNTERFOIL		Issued to holder of
Serial No. ..............................		Certificate of Registration No. .......................
To ............................................... (purchasing dealer) ............................................ (address) holding certificate of registration No. ............ dated .......................... under the West Bengal Sales Tax Act, 1994		Serial No. ......................................................
		To ............................................... (Purchasing dealer) ................................................... (Address) holding certificate of registration No. ................. dated ...................... under the West Bengal Sales Tax Act, 1994
Declaration given against:-
1	2	I/We the selling dealer mentioned below do certify that I/We am/are registered under the West Bengal Sales Tax Act, 1994 and *am/are holding certificate of registration No. ............. .................................. dated ............................
*Order/ Challan/ Bill/Invoice /Cash Memo Number and date	Quantity/Weight/Value of the goods sold to the purchasing dealer for the purpose of resale by him in West Bengal which fall within the provisions of section 17(2A)	I/We further certify that the goods particulars of which are given below were ordered for in your purchase. Order No. ............................... dated .................... /sold to you as per my/ our bill/invoice/cash memo stated below/ *supplied to you under our challan No. ........................... dated ..............................., for the purpose of resale by you in West Bengal.
		1	2
		Order/ Challan/ Bill/Invoice /Cash Memo Number and date	Quantity/Weight/Value of the goods involved in the transactions referred to in column 1, which fall within the provisions of section 17(2A)
		Note- Sign against last entry
Note-- Sign against last entry		Name and address of the selling dealer .......................... ........................................................
		Signature and status of the person signing the declaration
Date ..........................		Date ..........................

* Strike out the words or expressions which are inapplicable