THE GOA VALUE ADDED TAX RULES, 2005 FORMS
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Form VAT-II

[See rule 15(i)]

REGISTRATION CERTIFICATE UNDER SECTION 18 OF THE GOA VALUE

ADDED TAX ACT, 2005. (Act 9 of 2005)

TIN

1. TIN

2. WARD

3. NAME AND STYLE OF BUSINESS

4. PRINCIPAL PLACE OF BUSINESS

5. NATURE OF BUSINESS

6. ADDRESS OF ADDITIONAL PLACE OF BUSINESS, IF ANY:

(i)

(ii)

7. ADDRESSES OF WAREHOUSES , IF ANY:

(i)

(ii)

8. DATE OF LIABILITY

DD	MM	YY

9. DATE OF VALIDITY-

Registration is valid from

D D

M M

Y Y Y Y

D D

M M

Y Y Y Y

10. Dealer manufactures for sale the following classes of goods:-

11. The return in Form VAT-III is to be furnished by the dealer quarterly alongwith the receipt of the payment of Tax.

Date:-

(Seal of Assessing Authority)

______________________

Assessing Authority

_______Ward.

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NOTE

1) This Registration Certificate or copy thereof shall be displayed by the dealer at every place of business and it shall be produced for inspection on demand by any person exercising authority under the Act and rules.

2) Any change in the name, place of ownership of the business or number of places of business should be notified within 30 days and the Registration Certification got amended accordingly.

______________________________________________________________________________

RENEWAL

Date of renewal	Period to which renewed	Signature of Appropriate Assessing Authority.