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THE KERALA VALUE ADDED TAX RULES, 2005 - Forms
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THE KERALA VALUE ADDED TAX RULES, 2005

FORM No. 15

FORM OF DELIVERY NOTE

[See Rule 23 (3) and 58 (16) ]

(To be maintained in triplicate marked orginal, duplicate triplicate and serially machine numbered)

1. Book No./Serial No.  
 
SEAL

 

 

 
VAT OFFICE ADDRESS

 

2. Officer of Issue
 

 

 
3. Date (i) in figures

(ii) in words

of issue of way Bill by consignor

 
D D   M M   Y Y
               

 

4. Time of commencement of journery    
5. Name and address of the consignor  
TIN*                    
CST RC NO.                    

 

6. Name and address of the consignee  
TIN*                    
CST RC NO.                    

 

7. Place from which goods are consigned Place to which goods are consigned

8. If the consignor is transporting goods:

(a) In pursuance of sale for purpose of delivery to the buyer: or (e) From shop to godown to another shop or godown for purpose of storage or sale or;
(b) After purchasing them from registered dealers; or (f) To his principal having purchased them on his behalf; or
(c) After purchasing them from unregistered dealers or agriculturists (g) To his agent for sale on consignment basis
(d) From one of the shope or godown to an agent for sale (h) Other purposes (Specify)

(Mark "Tick" Whichever is applicable)

9. The Name and address and TIN, if any, of the Dealer/Person from whom goods were purchased/procured  
   
   

 

 

10. Description, quantity and value of goods. (i) in figures

(ii) in words

Sl. No Commodity Invoice No. Date Quantity Value of goods
         
         
         

11. Name and address of the owner of the goods vehicle or vessel by which the goods are organised

Name

Address

 

 
Vehicle/Vessel Number
 

 

 

I / We certify that to the best of my / our knowledge the particulars furnished herein are true, correct, complete and that nothing has been concealed therein.

Name, address and signature and Driving license of the driver of the vehicle
 
 

 

 

Name and dated signature of the Consignor or his authorised signatory

 

Free text box for instructions:  
SEAL OF DEALER

 

 

Note :-

1. Original to be furnished to the Assessing Authority concerned. Duplicate to be retained by the purchasing dealer or the person to whom goods were delivered for transporting, triplicate to be retained by the consigning dealer.

2. The entries in the duplicate and triplicate shall be carbon copies of the entries in the original. In the case of delivery notes issued in respect of goods intended to be transferred to place outside the State of Kerala, entries should be made in English. In any other case of transport such entries may be made either in English or in the language of the State namely, Malayalam, Tamil or Kannda, as the case may be.

3. Where the particulars of goods transported cannot be fully included under column 10 the dealer shall use separate sheet which shall be the delivery chalan referred to in Rule 58 (18)(A).

4. Any correctins or alterations made in the form should be duly attested by the person signing the form