FORM 40

Application for way bill in Form 42 for transport of goods imported into West Bengal by registered dealers

[See rule 215 read with rule 211, rule 212, or rule 213]

To

................................................... (*assessing authority/authorised officer),

.................................................... (name of *Charge/Division/Section/Circle/Checkpost.)

I, ..................................................... (name), .................................. (status of the applicant ) carrying on business under the trade name of ........................ holding certificate of registration No. ..................... do hereby apply under rule 215 for ........................ (state the number of forms) way bill in Form 42 required for the purpose of rule 211/rule212/rule 213 of the West Bengal Sales Tax Rules, 1995.

I declare that-

*(a) no way bill in Form 42 has been received by me on any previous occasion,

*(b) way bill in Form 42 has been received by me on the last two occasions as follows :-

(i) .................................... (here state the total number of forms) forms bearing SI. No. (s) ................ to ...................... on .............................. (date),

(ii) .................................. (here state the total number of forms) forms bearing SI. No. (s) ............... to ...................... on ................................ (date)

*(c) the stock of way bill in Form 42 held by me on the date of application is ........ (total number) bearing SI. No. (s) ...............

Please supply the way bills in Form 42 to *me/us/ ............ (specify full name) who is hereby duly authorised to receive the said form and acknowledge the receipt thereof. The attested signature of the authorised recipient is appended below.

Attested signature of the recipient : ...............................................

Status ..................................

* Strike out whichever is not applicable