The West Bengal Sales Tax - Forms
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FORM 59

Application for clearance certificate under section 94 (2) of the West Bengal Sales Tax Act, 1994

[See rule 273]

The Assistant Commissioner/Commercial Tax Officer

...............................Charge /Section

Sir,

I request that a certificate under sub-section (2) of section 94 of the West Bengal Sales Tax Act, 1994 be granted to me, I require the certificate for receiving payment for execution of a works contract.

*I am not liable to pay tax under section 21 of the said Act/I have paid tax payable by, or due from me under section 21 of the said Act.

I give below the necessary particulars :-

1.	Full name and address of the applicant :
2.	Name and address of the business of the applicant :
3.	Name and address of branches, if any, of the business :
4.	Particulars of proprietor/partner of the business :
	(a)	Name	:
	(b)	Father's name	:
	(c)	Residential address	:
	(d)	Permanent address
5.	Details of books of account maintained.
6.	Particulars of works for which the certificate is necessary :-
Name of the contractee			Contract No.	Date	Value of contract

I here by declare that the information of particulars furnished hereinbefore are true to my knowledge and belief.

Place :	Signature of the applicant.................................
	Status : ...............................................................

Certificate of clearance

The particulars set out above are verified and it is certified that the above mentioned applicant has -

* no liability to pay tax under section 21 of the West Bengal Sales Tax Act, 1994 :

* paid tax payable by, or due from him, under section 21 of the West Bengal Sales Tax Act, 1994.

Place :	Signature of the Commercial Tax Officer
Date :	...................................Charge/section