The West Bengal Sales Tax - Forms
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FORM 19

Statement of payment of tax deferred under section 40(1)/section 40(5) and paid under section 40(7) of the West Bengal Sales Tax Act, 1994

[See rule 112 (3), rule 125 (3)]

Name of the dealer ........................................................ carrying on business under the trade name of ................................ Address of the dealer .................................. Certificate of Registration No. ................................. No. of Certificate of eligibility for deferment of tax issued under section 40 and rules made thereunder and the date of issue ............................................

Location of the *newly set up industrial unit/expanded portion of an existing industrial unit/sick or closed industrial unit where goods were manufactured/goods were used in manufactured and in respect of which tax was deferred.

Period in respect of which tax was deferred	Break-up of amount of tax deferred		Total tax deferred	Tax is eligible for deferment up to (mention date)
(1)	(2)		(3)	(4)
	(a)	(b)
	tax as per returns under section 30(2)	tax as per notice under section 47

Amount of tax deferred as shown above has been paid by me by challan Number ............................. dated ............................ (*Government Treasury at ....................../ Reserve Bank of India at Calcutta).

The above statement is true to the best of my knowledge and belief.

	Signature ...................................
Date ...............................	Status .........................................