FORM VAT - 001

REGISTRATION CERTIFICATE FOR DEALERS LIABLE TO PAY TURNOVER

TAX.

[See sub-rule (1) of rule 18 and sub-rule(4) of rule 19 ]

I hereby certify that ___________________________ status ______________,

Whose principal business activities comprise ________________ and whose Principal Place of business / Place of business in located at :-

is registered / is deemed to be registred under sub-section (2) / sub-section (5) of\ section 25 or sub-section (2) of section 26 of the Orissa Value Added Tax Act, 2004 and is assigned with Identification Number.

S R I N

02. The additional place of business, branch, godown or warehouse is situated at the following address :

03. The following goods or class or classes of goods are purchased or intended to be purchased for resale.

04. Given under my hand at ________________ on the _____ day of _______, 200…

05. Your local Tax office is _______________________ CIRCLE.

Note :

Score out whichever is not applicable.

Use Block letters.