Sl No. ...........
Form of declaration to be issued by transferee under the Bihar Value Added Tax Act, 2005.
See Rule 26 (1)
Counterfoil
Name of issuing dealer --------------- along with his TIN --------------------------------------------
To
-------------- (transferor)
Taxpayer identification No.. ---------------------
Certified that the goods transferred to me/us as per details below have been received and duly recorded by me in my books of accounts.
Quantity and/ or weight ----------------
Value of goods -----------
Challan No. -------------- and date --------------- under which the goods were sent.
Mode of transport with vehicle No-------------.
No. & date of R.R. or lorry challan or any other documents indicating means of transport -------------
Date on which delivery was taken by the transferee ----------.
The above statements are true to the best of my knowledge and belief.
Signature.
Dated-------
status-------
(Name of the person signing the declaration with status)
Note: To be annexed by the transferor to his quarterly statement under rule 9(2).
Original
Name of issuing dealer --------------- along with his TIN -------------------------------------------
Taxpayer identification No.. --------------------
Quantity and/ or weight ---------------------
No. & date of R.R. or lorry challan or any other documents indicating means of transport-------------
Date on which delivery was taken by the transferee----------.
The above statement are true to the best of my knowledge and belief
Note: To be annexed by the transferor to his quarterly statement under rule 19(2).
Duplicate
Quantity and/ or weight ----------------------