FORM 4
Declaration
[See Rule 7 (3)]
DECLARATION
I,_________________(Name), of ______________(place) a dealer holding registration certificate No. _____________ under the Chhattisgarh Value Added Tax Act, 2005 hereby declare that I have dispatched during the quarter commencing from__________ and ending on___________ to _____________ (Name) of ________ (Place) _____________(name)a dealer holding registration certificate No.___________ under the said Act for sale on commission goods particulars of which have been given below,-
2. I further declare that tax under section 8 of the Act on the sale price of such goods at the hands of the commission agent has been paid by me
Particular of goods dispatched for sale on commission
*Strike out whichever is not applicable.