THE GOA VALUE ADDED TAX RULES, 2005 FORMS
-

FORM VAT-XVIII

[See rule 25 (1)]

ORIGINAL

(To be retained by the payer)

Chalan for remittance of tax deducted at source

Under section 28(2) of the Goa Value Added Tax Act, 2005. (Act 9 of 2005)

0040 - Taxes on Sales, trade, etc.

.......................................................

Remitted in..................................................................................

(Branch)

Treasury/Sub-Treasury State Bank of India

__________________

1. Name and Address of the Employer:

Payment of account of

Amount

(in figures )

Rs.

105-Value Added Tax

01-Tax Collection

02-Composition of tax

03-Licence &

Registration Fess

04-Interest

800-Others receipts

81-Other items

Total

2. Registration No...........................

3. TIN, if any available,

4. Period to which payment relates from

_______to ________

5. Amount remitted in figure :

Amount in words (Rupees ................. ......................................................only)

Place:

Date:

Signature of the employer or

authorised representatives

______________________________________________________________________________

(For use in the Treasury /Bank)

1. Received payment of Rs......................................................

(in figures)

Rupees ......................................................................................................................

(in words)

2. Date of entry................................................

3. Chalan/Scroll No...................................

(Signature of Accountant )

(Signature of Treasury / Bank of Officer / Manager )

(stamp of Treasury / Bank)

FORM VAT-XVIII

[See rule 25 (1)]

DUPLICATE

(To be furnished by the employer to the Appropriate Assessing Authority alongwith the statement)

Chalan for remittance of tax deducted at source

Under section 28(2) of the Goa Value Added Tax Act, 2005. (Act 9 of 2005)

0040 - Taxes on Sales, trade, etc.

.......................................................

Remitted in..................................................................................

(Branch)

Treasury/Sub-Treasury State Bank of India

__________________

1. Name and Address of the Employer:

Payment of account of

Amount

(in figures )

Rs.

105-Value Added Tax

01-Tax Collection

02-Composition of tax

03-Licence &

Registration Fess

04-Interest

800-Others receipts

81-Other items

Total

2. Registration No...........................

3. TIN, if any available,

4. Period to which payment relates from

_______to ________

5. Amount remitted in figure :

Amount in words (Rupees ................. ......................................................only)

Place:

Date:

Signature of the employer or

authorised representatives

______________________________________________________________________________

(For use in the Treasury /Bank)

1. Received payment of Rs......................................................

(in figures)

Rupees ......................................................................................................................

(in words)

2. Date of entry................................................

3. Chalan/Scroll No...................................

(Signature of Accountant)

(Signature of Treasury /Bank Officer/Manager)

(Stamp of Treasury /Bank)

FORM VAT - XVIII

[See rule 25 (1) ]

TRIPLICATE

(For the Treasury)

Chalan for remittance of tax deducted at source

Under section 28(2) of the Goa Value Added Tax Act, 2005. (Act 9 of 2005)

0040-Taxes on Sales, trade, etc.

......................................................

Remitted in.. ....................................................

(Branch)

Treasury /Sub-Treasury

State Bank of India

___________________

Name and Address of the Employer:

Payment on account of		Amount (in figures) Rs.
105	-Value Added Tax
01	-Tax Collection
02	-Composition of Tax
03	-Licence & Registration Fees
04	-Interest
800	-Others receipts
81	-Other items
Total

Registration No...........

TIN,if any available,

Period to which payment relates from

..............to...............

Amount remitted in figure:

Amount in words (Rupees ..................only)

Place:

Date:

Signature of the employer or

authorised representative

_____________________________________________________________________________

(For use in the Treasury /Bank)

1.	Received payment of Rs..........................................................................................
	(in figures)
	Rupees.....................................................................................................................
	(in words)
2.	Date of entry............................
3.	Chalan /Scroll No.....................

(Signature of Accountant)

(Signature of Treasury/Bank Officer/Manager)

(Signature of Accountant)

FORM VAT - XVIII

[See rule 25 (1)]

QUADRUPLICATE

(To be sent to the respective Appropriate Assessing Authority by the Treasury)

Chalan for remittance of tax deducted at source

Under section 28(2) of the Goa Value Added Tax Act, 2005. (Act 9 of 2005)

0040 - Taxes on Sales, trade, etc.

..........................................................

	Treasury/Sub-Treasury
Remitted in ........................................................	State Bank of India
(Branch)	___________________

1. Name and Address of the Employer:

Payment on account of		Amount (in figures) Rs.
105	-Value Added Tax
01	- Tax Collection
02	- Composition of Tax
03	- Licence & Registration Fees
04	- Interest
800	-Others receipts
81	-Other items
Total

2. Registration No..................

3. TIN, if any available,

4. Period to which payment relates from

___________to _________

5. Amount remitted in figure :

Amount in words (Rupees...........................only)

Place:
	Signature of the employer or
Date:	authorised representatives
____________________________________________________________________________

(For use in the Treasure/Bank)

1.	Received payment of Rs...................................................................................................
	(in figures)
	Rupees........................................................................................................................
	(in words)
2.	Date of entry...............................
3.	Chalan/Scroll No........................

(Signature of Accountant)

(Signature of Treasury/Bank Officer/Manager)

(Stamp of Treasury/Bank)