The Central Sales Tax (Orissa) Forms
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Body

FORM-V-1

[See rule 6(i) of the Central Sales Tax (Orissa) Rules 1957]

Statement of utilization of Declaration / Certificate Forms under the Central Sales Tax Act, 1956

Sl. No. Of Declaration Form with series No.	Date of issue	Dealer to whom the Form was issued		Invoice No. & date	Value (Rs.)	Sl. No. Of the Way Bill used ***	Name of the goods purchased ****
Sl. No. Of Declaration Form with series No.	Date of issue	Name, address and State of the selling dealer	CST R.C. No. (11 digit) **	Invoice No. & date	Value (Rs.)	Sl. No. Of the Way Bill used ***	Name of the goods purchased ****
(1)	(2)	(3)	(4)	(5)	(6)	(7)	(8)




Total

Certified to be true and correct.

* Strike out whichever is not applicable (maintain separate pages for each form)

** If, TIN assigned under the VAT Act and CST Act are different furnish both TIN and CST R.C No. in the order of : 1- TIN and 2-CST R.C No..

*** May be furnished wherever waybill is used.

* Where more than one type of goods are purchased, 'Mixed Goods' may be stated.