The Chhattisgarh Value Added Tax Rules, 2006. - FORMS
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FORM 67

[See rule 74 (4)]

INDEMNITY BOND

Know all men by these presents I____________________ S/o ________________________ registered dealer under the Chhattisgarh Value Added Tax Act. 2005 under the registration No.____________ (hereinafter called the Obligor is/are held and firmly bound unto Governor of Chhattisgarh (hereinafter called the Government) in sum of __________ (in figures) Rupees __________________ (in words) well and truly to be paid to the government on demand and without demur for which payment to be well and truly made I bind myself and my heirs, executors, administrators, legal representatives and assign/We bind ourselves, our successors and assign and the person for the time being having control over our assets and affairs.

Signed this ________ day of ___________ Two thousand and ____________ whereas sub-rule(4) of rule 74 of the Chhattisgarh Value Added Tax Rules, 2006 requires that in the event of a blank of a duly completed form of declaration is lost while it is in the custody of the dealer or in transit to the selling/purchasing dealer, to furnish an indemnity bond to the authority from whom the said form was obtained.

And whereas the obligor here is such dealer, and whereas the obligor has lost the declaration in *Form 59 bearing No.______________ * which was blank/duly completed, and was issued to him by _______ (Name and destination of the authority) ___________ in respect of the goods mentioned below (hereinafter referred to as the *"FORMS"

S.No.

No. of Bill/invoice challan

Date

Description of goods

Quantity

Amount

(1)

(2)

(3)

(4)

(5)

(6)

Now the condition of the above written bond of obligation is such that the obligor shall in the event of a loss suffered by the Government (in respect of which the decision of the Government or the authority appointed for the purpose shall be final and binding on the obligor) as a result of the misuse of the form.

Pay to the Government on demand and without demur the said sum of Rs.________ Rupees ____________(in words) and shall otherwise indemnify and keep the Government harmless and indemnify against and from all liabilities incurred by the Government as a result of the misuse of such form. Then the above written bond or obligation shall be void and of no effect but otherwise shall remain in full force, effect but otherwise shall remain in full force, effect and virtue. The obligor further undertakes to mortgage/charge, the properties specified in the schedule hereunder written by execution of proper deed of mortgage/charge for the payment of the said sum whenever called upon to do so by the assessing authority.

SCHEDULE

(Give details of the properties mortgaged/charged)

And these presents also witnesseth that the liability of the obligor hereunder shall not be impaired or discharged by reasons of and forbearance, act or omission of the Government or for any time being granted or indulgence shown by the Government or by reason of any change in the constitution of the obligor in cases where the obligor is not an individual.

The Government agrees to bear the stamp duty if any, chargeable on these presents. In witness where of the obligor *has set his hand/* has caused these presents executed by its authorized representatives, on the day, month and year above written.

Signed by the above named obligor

in the presence of-

1. _______________
2.________________	______________________
	Obligor's signature

Accepted for and on behalf of the Governor of Chhattisgarh by name and designation of the officer duly authorized in pursuance of article 299 (1) of the Constitution to accept the bond and on behalf of the Governor of Madhya Pradesh.

In the presence of-

1. _______________
2.________________	______________________
	(Name and Destination of the Officer)