THE WEST BENGAL VALUE ADDED TAX RULES, 2005 : FORMS
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THE WEST BENGAL VALUE ADDED TAX RULES, 2005

FORM 1A Omitted w.e.f. 1st August, 2011

Application for Registration for resellers purchasing or procuring goods from within West Bengal and not having any place of business outside the State

[See sub-rule (1) of rule 5]

01.

Compulsory under section 24(1)(a)

Voluntary under section 24(1)(b)

02.

Name of the Applicant

First Name

Middle Name

Surname

03.

Sex :

Male/Female :

04.

Father's Name/Husband/s Name

Trade Name

05.

06.

Address of the Principal place of business:

Room / Flat No.

Premises No. & Street

City/Town

District

Pin Code

Municipal / Local body

Telephone Number

07.

**Occupancy Status:

***Status of the business:

If partnership, number of partners:

*Address of other place of business in West Bengal:

08.

09.

10.

First place of business other than principal place of business [See section 2(29)]:

Room / Flat No.

Premises No. & Street

City/Town

District

Pin Code

Municipal / Local body

Telephone Number

Second place of business other than principal place of business [See section 2(29)]:

Room / Flat No.

Premises No. & Street

City/Town

District

Pin Code

Municipal / Local body

Telephone Number

11.

Where the reseller is a Company, the Registration Certificate Number as issued by the Registrar of Companies, West Bengal:

12.

Class or Classes of goods purchased or intended to be purchased for the purpose of resale of goods in West Bengal:

Taxable goods :-

Non-taxable goods :-

13.

*Details of Bank Account:

First Bank:

Name :

Branch :

Account No. :

Second Bank :

Name :

Branch :

Account No. :

14.

Registration/Enrolment Number (if any) under the West Bengal State Tax on Professions, Trades, Callings and Employments Act, 1979:

15.

PAN/TAN Number of the firm under the Income Tax Act, 1961 (if any):

16.

Certificate of Enlistment issued by the Municipal/Local Body:

(a) Number of the Certificate:

(b) Date of first issue of the certificate:

D	D		M	M		Y	Y	Y	Y

D	D		M	M		Y	Y	Y	Y

17.

Total amount of purchase and sale of goods in:

(a) Last year:

Purchases

Rs.

Sale

Rs.

(b) Current year, till the month preceding the date of application:

Purchases

Rs.

Sale

Rs.

18.

I/We have/have not acquired liability to pay tax under the West Bengal Value Added Tax Act, 2003 as a reseller for the first time from the date mentioned below:

D	D		M	M		Y	Y	Y	Y

I, .............................................................................. do hereby declare that the above statements are true to the best of my knowledge and belief.

Date .......................

Siganture ........................................................................

*(Proprietor/Partner/Karta/Managing Director/ Director/Company Secretary/Principal Officer/ Trustee/President/General Secretary)

Status ........................................................................

*Please use separate sheet wherever space is inadequate.

**Fill in the boxes with the appropriate code (given below) that identifies the occupancy status:

Owned-01

Rented-02

Leased-03

Rent-free-04

Others-05

***Please enter the two digit code that identifies the status of the business from the selection below:

Proprietory-01	Unregistered Partnership-02	Registered Partnership-03	Hindu Undivided Family-04
Private Limited Company-05	Public Limited Company-06	Public Sector Undertaking-07	Government Company-08
Statutory Body-09	Co-operative Society-10	Government-11	Other-12