Please fill in Capital letters where applicable and sign the declaration
Section A - Dealer Information
Section B - Filing Status
2
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Section C- Statement of Form 'A' Received from Purchaser of Liquor
Section D - Declaration
I, solemnly declare that to the best of my knowledge and belief, the information given in the return is correct and complete and that the particulars shown herein are truly stated and are in accordance with the provisions of the GST Act, 1962. (This return should be signed by an authorized person)