THE UTTARAKHAND (THE UTTARANCHAL VALUE ADDED TAX RULES, 2005) FORMS
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Body

ANNEXURE-001

of form IV (Amended)

COMPUTATION OF REVERSE TAX CREDIT DUE TO STOCK TRANSFER

1- TIN of the Dealer

2- Name and Address of the Dealer-

3- Period

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

4- Computation of reverse Tax Credit due to stock transfer -.

Signature

(Authorised Signatory)

Status-

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ANNEXURE-002

of form IV (Amended)

COMPUTATION OF REVERSE TAX CREDIT DUE TO OTHER REASONS

1- TIN of the Dealer

2- Name and Address of the Dealer-

3- Period

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

4- Computation of reverse Tax Credit due to other reasons-

Signature

(Authorised Signatory)

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ANNEXURE-003

of form IV (Amended)

TAX CREDIT ON SALE RETURNS

1- TIN of the Dealer

2- Name and Address of the Dealer-

3- Period

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

4. Details of Sale (taxable) return within the State (within six month) -

Sl. No.	Name and Address of the purchasing Regd. Dealer	TIN of the purchasing Regd. Dealer	Sale invoice no. and Date	Date on which goods received	Challan no. and Date through which goods received	Details of Credit/ Debit notes	Amount of Tax shown in Credit/ Debit note	Tax Credit claimed


			TOTAL

Signature

(Authorised Signatory)

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ANNEXURE-004

of form IV (Amended)

TAX CREDIT FOR REASONS OTHER THAN SALE RETURNS

1- TIN of the Dealer

2- Name and Address of the Dealer-

3- Period

4. Details of tax credit for reasons other than sale return-

Signature

(Authorised Signatory)

Status-

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ANNEXURE-005

of form IV (Amended)

TAX DEDUCTED AT SOURCE (TDS)

1- TIN of the Dealer

2. TDAN of the Person (if not a Regd. Dealer)

3. Name and Address of the Dealer-

4- Period

5- Details of TDS-

Sl. No.	Name and Address of the Employer/ Person who deducted the Tax	TIN of the Dealer from whom T.D.S. deducted	Amount of payment on which TDS deducted	Date of payment	Amount of TDS	Challan no. and Date by which TDS Deposited	Total amount of the Challan



				TOTAL

Signature

(Authorised Signatory)

Status-

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ANNEXURE-006

of form IV (Amended)

1- TIN of the Dealer

2- Name and Address of the Dealer-

3- Period

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

4. List Of form "XI" Submitted -

Sl. No.	Series and serial No of form XI	Name and Address of the purchaser	TIN of the purchaser	Assessment Year for which form issued	Amount covered by the form	Value for which concession claimed
1.
2.
	TOTAL (1+2+.....)

Signature of Authorised Signatory

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ANNEXURE-007

of form IV (Amended)

1- TIN of the Dealer

2- Name and Address of the Dealer-

3- Period

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

4. List of form "C" Submitted -

Sl. No.	Series and serial No of form "C" Submitted	Issuing State	Name and Address of the purchasing Dealer	TIN of the purchasing Dealer	Name of quarter (I, II, III or IV) to which form is related	Amount covered by the form	Value for which concession claimed
1.
2.
	TOTAL (1+2+.....)

Signature of Authorised Signatory

Status-

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ANNEXURE-008

of form IV (Amended)

1- TIN of the Dealer

2- Name and Address of the Dealer-

3- Period

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

4. List of form "H" Submitted -

Sl. No.	Series and serial No of form "H" Submitted	Issuing State	Name and Address of the purchasing Exporter	TIN of the purchasing Exporter	Name of quarter (I, II, III or IV) to which form is related	Amount covered by the form	Value for which concession / Exemption claimed
1.
2.
	TOTAL (1+2+.....)

Signature of Authorised Signatory

Status-

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ANNEXURE-009

of form IV (Amended)

1- TIN of the Dealer

2- Name and Address of the Dealer-

3- Period

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

4. List of form "I" Submitted -

Sl. No.	Series and serial No of form "I" Submitted	Issuing State	Name and Address of the purchasing SEZ Dealer	TIN of the purchasing SEZ Dealer	Name of quarter (I, II, III or IV) to which form is related	Amount covered by the form	Value for which concession / Exemption claimed
1.
2.
	TOTAL (1+2+.....)

Signature of Authorised Signatory

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ANNEXURE-010

of form IV (Amended)

1- TIN of the Dealer

2- Name and Address of the Dealer-

3- Period

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

4. List of form "J" Submitted -

Sl. No.	Series and serial No of form "J" Submitted	Issuing State	Name and Address of the purchasing International body	TIN (if any) of the purchasing International body	Name of quarter (I, II, III or IV) to which form is related	Amount covered by the form	Value for which concession / Exemption claimed
1.
2.
	TOTAL (1+2+.....)

Signature of Authorised Signatory

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ANNEXURE-011

of form IV (Amended)

1- TIN of the Dealer

2- Name and Address of the Dealer-

3- Period

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

4. List of form "F" Submitted

Sl. No.	Series and serial No of form "F" Submitted	Issuing State	Name and Address of the Receiving Dealer	TIN of the Receiving Dealer	Name of quarter (I, II, III or IV) to which form is related	Amount covered by the form	Value for which concession / Exemption claimed
1.
2.
	TOTAL (1+2+.....)

Signature of Authorised Signatory

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ANNEXURE-012

of form IV (Amended)

1- TIN of the Dealer

2- Name and Address of the Dealer-

3- Period

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

4. List of form "E-1" Submitted -

Sl. No.	Series and serial No of form "E-1" Submitted	Issuing State	Name and Address of the Issuing Dealer	TIN of the Issuing Dealer	Name of quarter (I, II, III or IV) to which form is related	Amount covered by the form	Value for which concession / Exemption claimed
1.
2.
	TOTAL (1+2+.....)

Signature of Authorised Signatory

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ANNEXURE-013

of form IV (Amended)

1- TIN of the Dealer

2- Name and Address of the Dealer-

3- Period

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

4. List of form "E-2" Submitted -

Sl. No.	Series and serial No of form "E-2" Submitted	Issuing State	Name and Address of the Issuing Dealer	TIN of the Issuing Dealer	Name of quarter (I, II, III or IV) to which form is related	Amount covered by the form	Value for which concession / Exemption claimed
1.
2.
	TOTAL (1+2+.....)

Signature of Authorised Signatory

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ANNEXURE-014

of form IV (Amended)

1- TIN of the Dealer

2- Name and Address of the Dealer-

3- Period

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

4. List Of Documents (Bill of lading/ air consignment note/ other documents) Submitted in Sport of export -

Sl. No.	Description of the document submitted	Name of Importing Country	No. and Date of the document Submitted	Sl. No. And Date of the Export Invoice	Invoice Value	Value of Export supported by the document	Value for which Exemption claimed
1.
2.
	TOTAL (1+2+.....)

Signature of Authorised Signatory

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ANNEXURE-015

of form IV (Amended)

1- TIN of the Dealer

2- Name and Address of the Dealer-

3- Period

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

4- List OF Other Certificates (Not covered by any other prescribed Annexure) Submitted-

SI. No	Description of the Certificate Submitted	Name and Address of issuing Authority	No. and Date of the Certificate Submitted	SI. No. and Date of the related Invoice	Invoice Value	Value Supported by the document	Value for which Concession/ Exemption claimed
1.
2.
	Total (1+2+......)

Signature of Authorized signatory

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ANNEXURE-016

of form IV (Amended)

1- TIN of the Dealer

2- Name and Address of the Dealer-

3- Period

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

4- Value of Opening and Closing stock.

SI. No	Name of commodity	Schedule of Rate	Serial No. In Schedule	General Rate of tax	Opening stock	Closing Stock	Remark
1.
2.
	Total (1+2+......)

Signature of Authorized signatory

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ANNEXURE-018

of form IV (Amended)

1- TIN of the Dealer

2- Name and Address of the Dealer-

3- Period

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

4- Reason of difference with sum of the Periodical Return-

Signature of Authorized signatory

Status-

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ANNEXURE-019(A)

of form IV (Amended)

1- TIN of the Dealer

2- Name and Address of the Dealer-

3- Period

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

4- List of Tax Charge (State) by Registered dealers for which ITC has been claimed-

SI. No	Name and Address of the selling Regd. Dealer	TIN of the selling Regd. Dealer	Total Tax charged in the invoices (on Non Capital Goods)	Total Tax charged in the invoices (on Capital Goods)	Total	Name of goods purchased
1.
2.
	Total (i+ii+...)

Signature of Authorized signatory

Status-

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ANNEXURE-019(B)

of form IV (Amended)

1- TIN of the Dealer

2- Name and Address of the Dealer-

3- Period

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

4- List of Tax Charge (State) from the Registered dealers-

SI. No	Name and Address of the purchasing Regd. Dealer	TIN of the purchasing Regd. Dealer	Total Tax charged in the invoices (on Non Capital Goods)	Total Tax charged in the invoices (on Capital Goods)	Total	Name of goods sold
1.
2.
	Total (i+ii+...)

Signature of Authorized signatory

Status-

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ANNEXURE-020

of form IV (Amended)

1- TIN of the Dealer

2- Name and Address of the Dealer-

3- Period

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

4- List of forms-16 used for Interstate Purchase/ Consignment- in-

SI. No	Series and S. No. of form-16	Name and Address of the Seller/ Sender	Invoice No.	Invoice date	Amount of Invoice	Description of goods	Remark


1.	Total of form-16 No. 1




	Total of form-16 No. 1

Grand Total of all the Form at No. 1, +2+ 3+...

Signature of Authorized signatory

Status-

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ANNEXURE-021

of form IV (Amended)

1- TIN of the Dealer

2- Name and Address of the Dealer-

3- Period

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

4- List of forms- C issued for Inter-state Purchase-

SI. No	Series and Sl. No. of form-C	Name and Address of the Seller	TIN of the Seller	Name of quarter (I, II, III or IV) to which form is related	Assessment year to which form is related	Invoice No.	Invoice date	Invoice Amount


1.	Total of form-C at Sl. No. 1



2.	Total of form-C at Sl. No. 2

Grand Total of all the Form at SI. No. 1, +2+ 3+...

Signature of Authorized signatory

Status-

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ANNEXURE-022

of form IV (Amended)

1- TIN of the Dealer

2- Name and Address of the Dealer-

3- Period

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

4- List of forms- H issued for Interstate Purchase-

SI. No	Series and Sl. No. of form- H	Name and Address of the Seller	TIN of the Seller	Name of quarter (I, II, III or IV) to which form is related	Assessment year to which form is related	Invoice No.	Invoice date	Invoice Amount


1.	Total of form-H at Sl. No. 1



2.	Total of form-H at Sl. No. 2

Grand Total of all the Form at SI. No. 1, +2+ 3+...

Signature of Authorized signatory

Status-

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ANNEXURE-023

of form IV (Amended)

1- TIN of the Dealer

2- Name and Address of the Dealer-

3- Period

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

4- List of forms-I issued for Interstate Purchase-

SI. No	Series and Sl. No. of form-I	Name and Address of the Seller	TIN of the Seller	Name of quarter (I, II, III or IV) to which form is related	Assessment year to which form is related	Invoice No.	Invoice date	Invoice Amount


1.	Total of form-I at Sl. No. 1



2.	Total of form-I at Sl. No. 2

Grand Total of all the Form at SI. No. 1, +2+ 3+...

Signature of Authorized signatory

Status-

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ANNEXURE-024

of form IV (Amended)

1- TIN of the Dealer

2- Name and Address of the Dealer-

3- Period

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

4- List of forms-J issued for Interstate Purchase-

SI. No	Series and Sl. No. Of form-J	Name and Address of the Seller	TIN of the Seller	Name of quarter (I, II, III or IV) to which form is related	Assessment year to which form is related	Invoice No.	Invoice date	Invoice Amount


1.	Total of form-J at Sl. No. 1



2.	Total of form-J at Sl. No. 2

Grand Total of all the Form at SI. No. 1, +2+ 3+...

Signature of Authorized signatory

Status-

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ANNEXURE-025

of form IV (Amended)

1- TIN of the Dealer

2- Name and Address of the Dealer-

3- Period

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

4- List of forms-F issued for Interstate Consignment in / Stock transfer - in-

SI. No	Series and Sl. No. of form- F	Name and Address of the Sender	TIN of the Sender	Name of quarter (I, II, III or IV) to which form is related	Assessment year to which form is related	Invoice No.	Invoice date	Invoice Amount


1.	Total of form- F at Sl. No. 1



2.				Total of form-F at Sl. No. 2

Grand Total of all the Form at SI. No. 1, +2+ 3+...

Signature of Authorized signatory

Status-

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ANNEXURE-026

of form IV (Amended)

1- TIN of the Dealer

2- Name and Address of the Dealer-

3- Period

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

4- List of forms- E-1 issued-

SI. No	Series and Sl. No. of form-E-1	Name and Address of the dealer to whom form issued	TIN of the dealer to whom form issued	Name of quarter (I, II, III or IV) to which form is related	Assessment year to which form is related	Invoice No.	Invoice date	Invoice Amount


1.	Total of form-E-1 at Sl. No. 1



2.	Total of form-E-1 at Sl. No. 2

Grand Total of all the Form at SI. No. 1, +2+ 3+...

Signature of Authorized signatory

Status-

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ANNEXURE-027

of form IV (Amended)

1- TIN of the Dealer

2- Name and Address of the Dealer-

3- Period

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

4- List of forms- E-2 issued-

SI. No	Series and Sl. No. of form-E-2	Name and Address of the dealer to whom form issued	TIN of the dealer to whom form issued	Name of quarter (I, II, III or IV) to which form is related	Assessment year to which form is related	Invoice No.	Invoice date	Invoice Amount


1.	Total of form-E-2 at Sl. No. 1



2.	Total of form-E-2 at Sl. No. 2

Grand Total of all the Form at SI. No. 1, +2+ 3+...

Signature of Authorized signatory

Status-

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ANNEXURE-028

of form IV (Amended)

1- TIN of the Dealer

2- Name and Address of the Dealer-

3- Period

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

4- List of forms-XI issued for Concessional State Purchase-

SI. No	Series and Sl. No. of form-XI	Name and Address of the Seller	TIN of the Seller	Name of quarter (I, II, III or IV) to which form is related	Assessment year to which form is related	Invoice No.	Invoice date	Invoice Amount


1.	Total of form XI at Sl. No. 1



2.	Total of form XI at Sl. No. 2

Grand Total of all the Form at SI. No. 1, +2+ 3+...

Signature of Authorized signatory

Status-

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ANNEXURE-029

of form IV (Amended)

1- TIN of the Dealer

2- Name and Address of the Dealer-

3- Period

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

4- List of form-8 issued for the Persons /Dealer from whom TDS Deducted-

SI. No	Series and Sl. No. Of form-8	Name and Address of the Person/Dealer to whom Form issued	TIN of the Person/Dealer to whom Form issued	Name of quarter (I, II, III or IV) to which form is related	Assessment year to which form is related	Amount of TDS for which form-8 issued
1.
2.
	Total (1+2+....)

Signature of Authorized signatory

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ANNEXURE-030

of form IV (Amended)

1- TIN of the Dealer

2- Name and Address of the Dealer-

3- Period

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

4- List OF OC Stamps used for Sale or for Transfer of Goods within State-

SI. No	Series and Sl. No. OC Stamps	Name and Address of the Purchaser/ Consignee	TIN of the Purchaser/ Consignee	Invoice No.	Invoice date	Amount of Invoice	Description of goods
1.
2.
	Total (1+2+....)

Signature of Authorized signatory

Status-

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ANNEXURE-031

of form IV (Amended)

1- TIN of the Dealer

2- Name and Address of the Dealer-

3- Period

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

4- Details of Due Tax, TDS, Interest & Late fess deposited along with periodical return-

SI. No.	Return Period	Due Date of submission of Return	Actual Date of Submission of Return	Delay in "Weeks"	Late fees Due	Amount of Due Tax or TDS	Due Date of Deposit	Actual Date of Deposit	Delay in "Month"	Interest Due
1.	April
2.	May
3.	June
4.	Quarter (I)
5.	July
6.	August
7.	September
8.	Quarter (II)
9.	October
10	November
11.	December
12.	Quarter (III)
13.	January
14.	February
15.	March
16.	Quarter (IV)
17.	Annual Report
18.	Total

Signature of Authorized signatory

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ANNEXURE-032

of form IV (Amended)

1- TIN of the Dealer

2- Name and Address of the Dealer-

3- Period

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

4- List of Annexure Submitted-

SI. No.	Description of Annexure	SI. No of Annexure
i.
ii.
iii.

Note: Only those Annexure are to be submitted which are applicable.

Signature of Authorized signatory

Status-

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SI. No

Description

Data in Annual Return

Sum of such data in Periodical Return

Difference

Details reason of difference

Annexure no. (self numbered) if submitted in support of such difference