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The Orissa Value Added Tax Rules, 2005 FORMS
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FORM VAT-612

CLEARANCE CERTIFICATE

[See sub-rule (2) of rule 129]

This is to certify that Sri/Smt._______________son/daughter/wife of _________________ (status)__________________ of M/s.________________ bearing TIN/SRIN__________________

(i) is in arrear of tax/interest/penalty amounting to Rs._____________ (Rupees ___________________________ ) for the period from______________ to ________________ which is covered under stay;

Or

(ii) is not in arrear of tax/interest/penalty and has filed return up to the tax period ending on __________.

This certificate is valid till the 31st March,______________.

Seal Assessing Authority
Place_______________ _________ Circle
Date________________