The Orissa Value Added Tax Rules, 2005 FORMS
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FORM VAT-406 Omitted w.e.f. 01-07-2017

APPLICATION, ISSUE AND RECEIPT OF TRANSIT PASS

[Refer sub-rule (1) of rule 83]

Part I

01. Name and address of the entry checkgate

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Signature

Designation

D	D		M	M		Y	Y	Y	Y
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(To be filled in by the owner of the goods or driver or person in-charge of the vehicle carrying the goods and, claiming to transit through the State)

02. Date on which reported at the checkgate

D	D		M	M		Y	Y	Y	Y
		-			-

03. Time of report

________________ A.M./P.M.

04. Name and full address of the destination place including the state of its location

05. Description of the goods, quantity and its value

Sl.No.	Commodity		Quantity	Value	Inv No./Date
	Description	Code No.

(Use additional sheet if required)

06. Name, address, TIN of the consignor

07. Name, address, TIN of the consignee

08. Registration No. of the vehicle in which the goods are transported

09. Name of the Transport Agency, if any

10. Name of exit checkgate in the State

11. Probable date and time of reporting at the exit checkgate

D	D		M	M		Y	Y	Y	Y
		-			-

_______A.M./P.M.

D E C L A R A T I O N

I, Sri _________________________, owner of the goods person in charge of the goods/driver of the vehicle do hereby declare that the information furnished above are true and correct. I further declare that the goods under transport shall not be unloaded, delivered or sold in the State.

Date ______________________

Place ______________________

Signature in full

(Name & Status)

Part II

TRANSIT PASS

No. _________________

D	D		M	M		Y	Y	Y	Y
		-			-

The vehicle bearing registration number ________________ is allowed to exit through the State. It will report at _____________________ checkgate at about ___________A.M./P.M. to exit the State.

To be generated in duplicate

Assistant Commissioner of Sales Tax /

Sales Tax Officer

_______________ Checkgate (ENTRY)

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Part III

No ________________

____________A.M./P.M.

D	D		M	M		Y	Y	Y	Y
		-			-

Received Transit Pass No _____________ dt. ___________ of __________ checkgate, which was issued to vehicle bearing registration number _______________, carrying goods as mentioned in Part I

Received

Full signature

Person in charge of the goods owner of the goods / Driver of the vehicle

Assistant Commissioner of Sales Tax /

Sales Tax Officer

________________ CHECKGATE (EXIT)

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