The West Bengal Sales Tax - Forms
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FORM 13A		FORM 13A
Form of Certificate		Form of Certificate
*(See rule 77 (2) and rule 84)*		*(See rule 77 (2) and rule 84)*
Issued to holder of Registration Certificate No. ...............................		Issued to holder of Registration Certificate No. ...............................
COUNTERFOIL		Serial No. .............................
Serial No. .............................		Issued by the selling dealer to .............................. .................................... (Purchasing dealer) ..................................................... (address) holding certificate of registration No. ............................
Issued by the selling dealer to .............................. .................................... (purchasing dealer) ..................................................... (address) holding certificate of registration No. ............................		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 ..........................
Certificate given against :-		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 ...................
1	2
*Order/Challan/Bill/Invoice/ Cash Memo Number and date	*Quantity/Weight/Value of the goods specified in Schedule II involved in the transactions referred to in column 1, which fall within the ambit of the proviso to section 17A (4)
		I/We also certify that tax in respect of purchase within West Bengal of the said goods is/has been paid by me or us/is exempted or to be exempted under section 39/remitted or to be remitted under section 41.
		*I/We also certify that tax collected on sale of the said goods from the purchaser will be deposited to the appropriate Government treasury in accordance with law
		1	2
		*Order/Challan/Bill/Invoice/ Cash Memo Number and date	*Quantity/Weight/Value of the goods specified in Schedule II involved in the transactions referred to in column 1, which fall within the ambit of the proviso to section 17A (4)
		Note :- Sign against last entry
		Name and address of the selling dealer
Note-- Sign against last entry		..........................................................................
		..........................................................................
Date		Signature and status of the person signing the certificate
		Date ...............................

* Strike out the words or expressions which are inapplicable