Andhra Pradesh Value Added Tax Rules, 2005- Forms
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FORM 526

DECLARATION TO BE ISSUED BY THE DEALER WHO PURCHASES AND USES THE GOODS AS INDUSTRIAL INPUTS.

(See note 6 appended to Schedule IV of APVAT Act.)

I / We carrying on business in the name of M/s.__________________

_____________________with TIN ______________ hereby declare that the goods purchased by me/us are enumerated under entry 100 of IV schedule to APVAT Act, 2005, and the said goods have been purchased for the purpose of using them as industrial inputs and not for any other use.

The details of goods purchased are as under:

1. Name and address of the dealer from whom the goods are purchased :

2. TIN of the selling dealer :

3. Details of the goods purchased,

Sl.No	Description of goods	HSN Code	Invoice No and Date.	Amount set out in the invoice

The information furnished above is true and correct, and we shall be liable to penalty if the goods so purchased are used for the purposes other than specified and we shall also be liable to penalty if this declaration is found to be false or fabricated.

Place:	Name and signature of the
Date:	person authorized to sign.