(Required for adjustment of VAT payable by SICOP on account of purchase of raw material from the dealer).

1. Name and full address of the dealer:-

2. TIN of the dealer

It is certified that the raw material purchased by SICOP from M/s .............................. having TIN .................. as per below mentioned invoice(s) are meant for onward sale to M/s ............................... registered Micro

and Small Industrial (SII) Unit(s) of the J&K State bearing TIN ........................... and duly covered in certificate of registration (s) as raw material for manufacture of their finished products.

The tax amounting to Rs. ........................... (in words) ............................... is debited against the advance tax of Rs.............................. (in words) (.....................................) credited by the Industries and Commerce department in major head 0040 sales tax as no tax has been paid in cash to the dealer by the SICOP.

Further it is certified that the raw material purchased for the aforementioned industrial unit shall be sold to M/s ................................... (industrial unit) during the quarter of the purchase.

The certificate is being issued in lieu of the tax amount due to the dealer and shall be furnished alongwith quarterly return due for the tax period.

For & On behalf of Managing Director SICOP

i. To be furnished to the Commercial Taxes Department

ii. To be retained by the SICOP

iii. To be retained by the selling dealer

iv. To be retained by the industrial unit(s)