THE KERALA VALUE ADDED TAX RULES, 2005

FORM NO.6B

INDEMNITY BOND

(to be furnished when valuable forms are lost)

{ See Rule 62 (2) }

Know all men by these presents that

I/We .....................S/o.................................registered dealer under the Kerala Value Added Tax Act, 2003 , with Tax Payer's Identification No....................................dated .......................................in the State of....................

We/M/s. ....................a firm/ a company registered under the laws of India and having its registered office at....................registered dealers under the Kerala Value Added Tax Act, 2003, with Tax Payer's Identification No.............in the State of......................(hereinafter called the obligor) is/are held and firmly bound unto the Governor of Kerala hereinafter called the Government) in sum of................... {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/We bind myself/ourselves and my/our heirs, executors, administrators, legal representatives and assignees, I/We bind myself/ourselves, our successors and assignees and the person for the time being having control over my/our assets and affairs.

Signed this...................day of...........................Two thousand............................

Whereas Rule ................of the Kerala Value Added Tax Rules, 2005, required that in the event a blank or a completed form of declaration is lost while it is in custody of the purchasing authorized dealer or in transit to the selling registered dealer, the purchasing authorized dealer and as the case may be also a selling registered dealer each to furnish an indemnity bond to, in the case of the purchasing authorized dealer, the assessing authority from whom the said declaration was obtained and in the case of a selling registered dealer, the assessing authority of the area in whose jurisdiction the said selling registered dealer is registered.

And whereas the Obligor herein is such *purchasing authorized dealer* selling registered dealer.

And whereas the Obligor has lost the declaration in Form.....................bearing No...... which was blank/*completed and was issued to him by...................(name and designation of the authority).......... Which was issued to him by .....................................(name and designation of the authority)................................ and sent to ..............................................(selling registered dealer)...................*received by him from...................(name of the purchasing authorized dealer)...................and sent to ..........................(assessing authority of the selling registered dealer's State.....................) in respect of the goods mentioned below (hereinafter referred to as the declaration)

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 purposes shall be final and binding on the Obligor)as a result of the misuse of the declaration, 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 indemnified against and from all liabilities incurred by the Government as a result of the misuse of such declaration, then the above written bond or obligation shall be void and of no 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 up to do by the assessing authority.

SCHEDULE

(Give details of properties mortgaged/charged)

And these presents also witnesseth that the liability of the Obligor hereunder shall not be impaired or discharged by reason of any 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 whereof 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

Accepted for and on behalf of the Governor of Kerala

In presence of:

1.........................

2.........................

"*Strike out which is not applicable."