Bihar Value Added Tax Rules, 2005 FORMS
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Form A-III

Application for grant of certificate for non-deduction of tax form bills of a supplier registered under the Bihar Value Added Tax Act, 2005

[See Rule 28(2)]

Office of the ____________________________ of Commercial Taxes ____________________ Circle

To,

The____________________________

____________________________circle.

I ________________________ (full name) son of ____________________________ (full name) hereby apply for the grant of certificate in form C-III under rule 28(1)(b) of the Bihar Value Added Tax Rules, 2005 and furnish the following particular for that purpose

1.	Name and style of the firm	.....................................................................................
		.....................................................................................
2.	Taxpayer Identification Number	.....................................................................................
3.	Name and complete address of the authority/person to whom the goods are to be supplied	.....................................................................................
		.....................................................................................
		.....................................................................................
4.	Value of the goods to be supplied	.....................................................................................

DECLARATION

I do hereby declare that particulars furnished in this application are correct and complete to the best of my knowledge and belief.

I further declare that tax payable in regard to the supplies mentioned at serial number 4 above shall be deposited by me in ___________________________ (Name of the circle) as and when the tax thereon becomes due for payment.

Date __________________	Signature of the applicant _________________________
Place __________________	Status in relation to the dealer ______________________