The West Bengal Sales Tax - Forms
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FORM 25B

[See rule 175(4)]

*Return/Statement of tax payable under section 17C of the West Bengal Sales Tax Act, 1994 as per books of accounts maintained on the basis of mercantile system for the quarter ending the ............... day of .............................

Name of the dealer .................................................... carrying on business under the trade name of ....................................

Address of the dealer .......................................................................................................................

......................................................................................................................

Dealer's registration certificate No. under the Act ..............................................................................

Permanent Account No. of the dealer under the Income Tax Act, 1961 ................................................

Enrolment certificate No. of the dealer under the West Bengal State Tax on Professions, Trades, Callings and Employments Act, 1979 ..........................................................

Computation of tax payable under section 17C

Sl. No.	Type of draw	No. of draws during the quarter	Compound rate per draw	Tax payable
(1)	(2)	(3)	(4)	(5)
1.	Draw for tickets having a price up to Re. 1/-	......................	Re..................	Rs....................
2.	Draw for tickets having a price
	above Re. 1/- and up to Rs. 2/-	........................	Rs................	Rs....................
3.	Draw for tickets having a price
	above Rs. 2/- and up to Rs. 5/-	......................	Rs................	Rs....................
4.	Draw for tickets having a price
	above Rs. 5/- and up to Rs. 10/-	........................	Rs.................	Rs.................
5.	Draw for tickets having a price
	above Rs. 10/- and up to Rs. 50/-	.......................	Rs...............	Rs.................
6.	Draw for tickets having a price
	above Rs. 50/- and up to Rs. 100/-	......................	Rs...................	Rs...............
7.	Draw for tickets having a price
	of Rs. 100/- and up to Rs. 500/-	.....................	Rs...................	Rs.................
8.	Draw for ticket having a price above
	Rs. 500	.....................	Rs...................	Rs.................

Tax paid in accordance with sub-rule (5) of rule 175:-

Sl. No.	Challan No. & date	*Reserve Bank of India, Calcutta/Government Treasury.	Amount
1.	................................	................................	Rs. ............................
2.	................................	................................	Rs. ............................
3.	................................	................................	Rs. ............................
		Total	Rs. ............................

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

Date .........................................
	.....................................................................
	(Signature with status)