THE UTTARAKHAND (THE UTTARANCHAL VALUE ADDED TAX RULES, 2005) FORMS
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FORM XXII

(See sub-rule (2) of rule 11 )

Application for Composition of Tax under sub-section (1) of section 7 of the Uttaranchal Value Added Tax Act, 2005

To,

The Assessing Authority, Commercial Tax

Sector__________Circle___________

ASSESSMENT YEAR

REGISTRATION NUMBER

1-(a) Name of applicant

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(b) Father's / Husband's name:

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(d) Status in business :

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2- Name and style of business

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3- Principal place of business in Uttaranchal with complete address:

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Tel.Ph.No. ----------Fax -------- e-mail -----------

4-Branches in Uttaranchal

1--------------------------------------------------

2--------------------------------------------------

3--------------------------------------------------

4--------------------------------------------------

5-Details turnover of Sales in the previous year-

(a)(i) Gross Sales under State Act

Rs.--------------------

(ii) Gross Sales under CST Act

Rs.--------------------

Grand Total

Rs.--------------------

(b)Details of Gross Sales under State Act

Rs.--------------------

(i) Sales of Special Category Goods specified in Schedule III

Rs.--------------------

(ii) Sales of Goods specified in Schedule II

Rs.--------------------

(iii)Balance Amount of Sales within the State

Rs.--------------------

Grand Total

Rs.--------------------

6- If the dealer has opted for Composition Scheme under sub-section (1) of Section 7 of the Act in the previous years, give details-

Year	Turnover under Composition Scheme	Amount of tax under Composition Scheme

Passport size photograph of the applicant to be affixed

DECLARATION

I, --------------------------------------------(applicant) do hereby

declare that-

(a) the dealer does not manufacture goods within the State;

(b) the dealer does not import goods from outside the State or import goods from outside the territory of India;

(c) the dealer's gross turnover of sales within the State in the previous year, excluding the sale of goods specified in Schedule II(C) and Special Category Goods specified in Schedule III, does not exceed Rs. 50 lacs; and

(d) the dealer opts to pay, in lieu of tax under the provisions of the Act, a tax @ 1% of the entire turnover of sales within the State, excluding the sale of goods specified in Schedule II(C) and Special Category Goods specified in Schedule III of the Act, as per the provisions of, and subject to the conditions and restrictions applicable to, the Compounding Scheme under sub-section (1) of section 7 of the Act.

I further certify that the particulars furnished in this application are true and complete to the best of my knowledge and belief, and no material particular has been concealed.

Place :--------------------	Signature of the applicant ------------------------------
Dated:---------------------	Name : -----------------------------------------------
	Status in business -------------------------------------
	(SEAL)

WITNESS :
Signature	(1)	-------------------------------------	(2)	-------------------------------------
Name :		-------------------------------------		-------------------------------------
Parentage :		-------------------------------------		-------------------------------------
Full address :		-------------------------------------		-------------------------------------
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Signature and details of the person who has attested signature and photograph of the applicant

Signature :

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Name :

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Status :

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(SEAL)