FORM VAT-101A
DETAILS OF ADDITIONAL PLACES OF BUSINESS / BRANCHES / GODOWNS /
/ WAREHOUSES IN ORISSA.
[ See clause (a) of sub-rule (9) of rule 15]
02. Address:
03. Name of the applicant:
(Score out whichever is not applicable)
ADDRESS __________________________________________________________________
____________________________________________________________________________
Pin Code __________________Telephone ________________ Fax __________________
ADDRESS__________________________________________________________________
___________________________________________________________________________
Pin Code _______________________Telephone ________________ Fax _______________
ADDRESS___________________________________________________________________
Pin Code ____________________Telephone ________________ Fax ______________
VERIFICATION
I _____________________ son / daughter / wife of _______________________ status __________ of the aforesaid business do hereby solemnly affirm that the particulars given in this form are true and correct to the best of my knowledge and belief.
.
Signature