Form - VAT XXIII

(See rule 41 of the Goa Value Added Tax Rules, 2005)

CERTIFICATE OF RECOVERY OF ARREARS

(1) Full Name and address of the defaulter;

(3) The name of the person or persons, if any,

responsible for the payment of amount due;

(4) The sum to be received;

(5) Period to which the sum relates;

(6) The provisions of law under which the sum is

recoverable as an arrears of land revenue;

(7) The process by which the sum may be recovered

(8) The property against which the process may be executed;

(9) The head of account to which the amount should becredited; and

(10) Any other information relevant for the purpose of recovery of the arrears.

Dated

To,

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