The Orissa Entry Tax - Forms
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FORM E 3A

[see rule 10 (1) (c)]

Particulars of sale of scheduled goods made against declaration in Form E 15 or E 16 or both

Sl. No.	Invoice No. & date	Name & address of the purchasing dealer	TIN/SRIN/Identification no.	Description of scheduled goods	Value of goods	Number of Forms E 15 received

Sl. No.	Invoice No. & date	Name & address of the purchasing dealer	TIN/SRIN/Identification no.	Description of scheduled goods	Value of goods	Number of Forms E 16 received

(attach original declaration in Form E 15/E 16/ both along with the statement E 3A)