THE WEST BENGAL VALUE ADDED TAX RULES, 2005

FORM 57

Application for way bill in Form 51 for transport of goods from any place in West Bengal to any place outside West Bengal by a dealer, other than a registered dealer, casual dealer or person,

[*sub-rule (1) of rule 111 / with sub-rule (1) of rule 112 read with rule 108]

To,

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

[*asessing authority/authorised officer mentioned in rule *111/112]

....................................................... (Name of *Charge / Division / Circle / Check-Post.)

*I/We ....................................................................... (name) *am/are-

*(a) not a dealer, or a casual dealer

(b) a casual dealer

(c) carrying on business as a dealer under the trade name of .......................................... at ............................ (address) and * I am/We are not registered under the West bengal Value Added Tax

Act, 2003,

and do hereby apply under *rule 111 / rule 112 of the West Bengal Value Added Tax Rules, 2003 for ................................. (state the number ) of way bills in Form 51 as required under rule 108 for the purpose of transport of goods outside West Bengal by *me/us (Particulars of which are given below):

I/We declare that-

*(a) I am/we are not liable to pay tax under the said Act,

*(b) I am/we are liable to pay tax under that Act as a dealer and *I have/have not applied for registration under section 24.

*I/We further declare that-------

*(a) no way bill in Form 51 has been received on any previous occasion by me.

*(b) way bill in Form 51 has been received by me on the last occasion/last two occasions as follows:-

(iii) ...........................(here state the total number) forms bearing Sl. No. (s)

................ to ......................on ....................(date).

(iv) .............................(here state the total number) forms bearing Sl.No. (s)

..................to .......................on.....................(date).

*(c) the stock of way bill in Form 51 held on ................(date of application)

is ..............(total number) bearing Sl.No. (s)............................

*Separate statement in Form 55 of receipt and issue of way bill in Form 51 as required under *sub-rule (3)

of rule 111/under sub-rule (3) of rule 112.is enclosed herewith.

Particulars of the consignment of goods in respect of which way bills are required (use separate sheet if consignment is more than one).

*I/We do hereby verify and declare that what is stated in this application is true to the best of my/our knowledge and belief.

Please supply the way bills in Form 51 to *me/us.................................(specify full name) who is hereby

duly authorised to receive the said form and acknowledge the receipt thereof. The atttested signature of the authorised recipient is appended below.

Attested signature of the receipient..........................................

Signture..........................................

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

Address of *place of....................................

business/residence...................................

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

_____________________________________________________________________________________

*Strike out whichever is not applicable.