THE KERALA VALUE ADDED TAX RULES, 2005

FORM NO. 25 D

DECLARATION TO BE FURNISHED BY PRINCIPAL WHEN INPUT TAX CREDIT IS CLAIMED BY AGENT

(see rule 12B)

Declaration

I/We...................... (here enter name and address of the Principal with TIN), a dealer registered under the KVAT Act, 2003 at ..................... (VAT office address) do hereby authorize my/our agent M/s ....................... (here enter name and address of the agent with TIN) for availing of input tax credit/special rebate/refund in respect of taxable goods sold on our behalf and also hereby assign the liability for any reverse tax under section 11 (7) to the said agent in the event of irregular availing of input tax credit in respect of transactions at the hands of the said agent.

I/We here by declare that I/We have effected local purchases of the goods details of which are given below within the state for which input tax creidt/special rebate/refund in admissible under section 11 / section 12 / section 13 of the Act and that taxable goods ..................... (description of good with schedule no / entry / section / ) in relation thereto have been entrusted for sale to M/s ............................. As our agent.

I/We further declare that I/We have not claimed and will not claim input tax credit/refund/purchase return relating to the above input tax amounting to Rs..................... either at a VAT office or through any other agent, that originals of tax invoices mentioned above are kept with us for any verification and that certified copies of such tax invoice have been provided to the agent M/s ..........................

The above statements are true to the best of my knowledge and belief.