The Central Sales Tax (Orissa) Forms
-

Body

FORM VI

Assessment Order under rule 15 of the Central Sales Tax (Orissa) Rules, 1957

1. Office Address

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

Date	Month	Year

3. TIN

3. Dealer / dealer' authorised representative appeared with books of account (Yes/No)

YES

[Please put ' ' mark in appropriate box]

4. Name & Address of the dealer

5. Period(s) covered under this order

	Date	Month	Year
From

	Date	Month	Year
To

6. Assessment under rule _______________________for CST (O) Rule, 1957.

(Strike out whichever is not applicable)

7. GTO declared	Rs.
8. Net Turnover declared.	Rs.
9. GTO determined.	Rs.
10. Net taxable turnover determined.	Rs.
11. Tax assessed.	Rs.
12. Interest levied..	Rs.
13. Penalty imposed.	Rs.
14. Total of amount of tax, penalty & Interest due	Rs.
15. Tax paid	Rs.
16. (i) Amount of interest paid	Rs.
(ii) Amount of penalty paid	Rs.
17. (i) Balance Tax due	Rs.
(ii) Balance Interest due	Rs.
(iii) Balance Penalty due	Rs.
18. Total amount of tax, interest and penalty due to be paid [Col.17(i) to 17(iii)]	Rs.
19. Refundable amount, if any	Rs.

ORDER

ASSESSING AUTHORITY

SIGNATURE

DESIGNATION