KERALA VALUE ADDED TAX RULES, 2005

FORM No.4A replaced with a new Form No. 1A w.e.f 01-04-2011

CERTIFICATE OF REGISTRATION

PRESUMPTIVE TAX DEALER

(Not Transferable)

[See Rule 17(14)]

TIN

PHOTO

(To be attested

by RA/AA)

This is to certify that registration under Section 16 of the Kerala Value Added Tax Act, 2003 has been granted to

Business Name & Address
Status (Indicate whether Proprietor/Partner/Company)
Full Name of Proprietor/Mg. Partner/Mg.Director

1. This certificate is valid from ........ (date)until cancelled/ suspended/ surrendered and subject to renewal every year as per Rules.

2. This certificate is issued for the principal place of business/ branch place of business at ................ ( Strike out whichever is not applicable).

3. Details of Branches (if any)

4. Details of godowns

5 Description of goods dealt with.

Place:	Signature of the Registering Authority
Date:	Name, Designation and Office.
(Seal)