Download Registration as a Dealer

FORM D Application for Registration as a Dealer under Section 12 of The Andhra Pradesh General Sales Tax Act, 1957 (See Rules 28 and 29 of A.P.G.S.T. Rules, 1957) To The Assistant / Deputy Commercial Tax Officer, Division ______________________________ Circle ______________________________ Unit ______________________________ I______________________________________________________________________(Name of the applicant) carrying on the proprietor business known as____________________________________ ___________________________________________________________(Name of Proprietary) here by apply for registering me under Section 12 of the Andhra Pradesh General Sales Tax Act, 1957. OR I______________________________________________________________________(Name of the applicant) the________________________________________________**(Status of applicant in the firm) of the____________________________________________***(Status of firm) Carrying on the business known as _________________________________________________________________ (Name of the business) hereby apply for registering, the said________________________________ ***(Status of firm) under Section 12 of the Andhra Pradesh General Sales Tax Act, 1957. ** Status of applicant in firm may be http://www.esevaonline.com/htmlpages/Forms/Apgst/form_d.htm (1 of 19) [7/1/2008 3:05:00 PM] 1. Partner 2. Managing Director 3. Secretary 4. Principal Officer 5. Trustee 6. Any other status *** Status of firm may be 1. Partnership 2. Private Ltd., 3. Public Ltd., 4. Society 5. Trust 6. Club 7. Association 8. Govt. Company 9. Hindu Undivided Family 10. Works Contract 11. Hotels The particulars of the above business are given below. 1. Name and full postal address of the principal place of business with the particulars of building, name and number, ward name and number, street name etc., Name _________________________ Address __________________________ Building Name _________________________ Building Number____________________________ http://www.esevaonline.com/htmlpages/Forms/Apgst/form_d.htm (2 of 19) [7/1/2008 3:05:00 PM] Ward Name _________________________ Ward Number ______________________________ Street / Road _________________________ Village / Town _________________________ STATE____________________________________ District _________________________ Pin code___________________________________ 2. Name and full postal address of all the other places of business in the state with particulars of building, name and number, ward name and number, road name, street etc., of each place of business (if the space in this column is found to be insufficient additional sheets may be used and duly signed) Name _________________________ Address _________________________ Building Name _________________________ Building Number ____________________________ Ward Name _________________________ Ward Number ______________________________ Street / Road _________________________ Village / Town _________________________ STATE____________________________________ District _________________________ Pin code___________________________________ Page number(s) of additional sheet(s) used______________________________________________ 3. (a) Name and full address of all the other places of business outside the state with full details as required under Column 2. (Attach additional sheets if required). Name _________________________ Address _________________________ Building Name _________________________ Building Number ____________________________ Ward Name _________________________ Ward Number ______________________________ Street / Road _________________________ Village / Town _________________________ STATE____________________________________ District _________________________ Pin code___________________________________ Page number(s) of additional sheet(s) used______________________________________________ http://www.esevaonline.com/htmlpages/Forms/Apgst/form_d.htm (3 of 19) [7/1/2008 3:05:00 PM] (b) Name and full address of registered office of business, is situated outside the state of A.P. along with Registration Certificate number. Registration Certificate No ___________________________________________________________ Name _________________________ Address _________________________ Building Name _________________________ Building Number ____________________________ Ward Name _________________________ Ward Number ______________________________ Street / Road _________________________ Village / Town _________________________ STATE____________________________________ District _________________________ Pin code___________________________________ Page number(s) of additional sheet(s) used______________________________________________ 4. Complete list of godowns in which the goods relating to the business are stored and address of every such godown (Attach additional sheets in the given format, if required) Name _________________________ Address _________________________ Building Name _________________________ Building Number ____________________________ Ward Name _________________________ Ward Number ______________________________ Street / Road _________________________ Village / Town _________________________ STATE____________________________________ District _________________________ Pin code___________________________________ Page number(s) of additional sheet(s) used______________________________________________ 5. Description of all classes of goods either bought, sold, manufactured, supplied, distributed etc., by the dealer (Attach additional sheets if required) http://www.esevaonline.com/htmlpages/Forms/Apgst/form_d.htm (4 of 19) [7/1/2008 3:05:00 PM] 1 6 2 7 3 8 4 9 10 Page number(s) of additional sheet(s) used______________________________________________ 6. Date of Commencement of business Date ______ Month ___________________ Year ________ 7. The language in which the Accounts are Kept and maintained____________________________ 8. The accounting year followed by the dealer for the purpose of Income Tax Act. From __________________ To _________________ 9. Name(s) and addresses of the proprietors, partners, all persons having any interest in the business (Additional sheet with the following columns shall be used, if necessary). Page number(s) of additional sheet(s) used ___________________________________________ (a) Serial number _____________________________________________________________ (b) Name in full of the person _____________________________________________________ (c) Name of father of the person ___________________________________________________ (d) Age of the person ___________________________________________________________ http://www.esevaonline.com/htmlpages/Forms/Apgst/form_d.htm (5 of 19) [7/1/2008 3:05:00 PM] (e) Permanent postal address of the person _________________________________________ (f) Present postal address of the person __________________________________________ (g) Extent of interest of the person in the Business __________________________________________ (h) Signature of the person _________________________________________ (i) Name, address and signature of witness attesting signature and identifying the persons (The identification should be by 2 dealers who are registered under the Act). a) Partners names & signatures 4 9 Witness (Registered dealer) 10. Particulars of other interests, if any, in other business concerns or other concerns, such as shares and stocks, investment in chit funds, securities, defence certificates, National Savings Certificates, Central and State loans including those floated by Public Undertakings, deposits including Bank accounts and movable and immovable operaties of the properties, partners, members in the business, both in State and in other States (Please append a list containing these particulars, in respect of each member). Page number(s) of additional sheet(s) used __________________________________________ 11. Particulars of registration certificate if any, held by the dealer, before the submission of this application under the General Sales Tax Act, with the name of the office from where the certificate has been obtained with number and date of certificate. Division __________________________________________ Circle __________________________________________ Unit __________________________________________ No. __________________________________________ Date : __________________________________________ 12. Particulars of Central Sales Tax Registration Certificate, if any, held by the dealer with the name of the office, where such certificate has been obtained with number and date of certificate. Division __________________________________________ Circle __________________________________________ Unit __________________________________________ No. __________________________________________ Date __________________________________________ 13. General nature of business: (Tick whichever is applicable) 1. Wholesale 2. Retail 3. Manufacturing 4. Agency 5. Distribution 6. Stockist 7. Leasing Company 8. Hotel 9. Works Contract 10. If any other, specify 14. Details of goods ordinarily purchased by the dealer for (Attach additional sheets if required) http://www.esevaonline.com/htmlpages/Forms/Apgst/form_d.htm (8 of 19) [7/1/2008 3:05:00 PM] (a) Use as raw materials in the manufacture of goods for sale Page number(s) of additional sheet(s) used ______________________________________________ Page number(s) of additional sheet(s) used______________________________________________ Page number(s) of additional sheet(s) used______________________________________________ (d) Despatch outside the State Page number(s) of additional sheet(s) used______________________________________________ Page number(s) of additional Sheet(s) used______________________________________________ 16. Name and address of the Chambers of Commerce, Trade Association etc., of which the dealer is a member : (Attach additional sheets, if required) Page Number(s) of additional sheet(s) used______________________________________________ 17. The total turnover of the year preceding to which the application is submitted. : 18. Actual turnover of the year upto date of submission of the application : http://www.esevaonline.com/htmlpages/Forms/Apgst/form_d.htm (10 of 19) [7/1/2008 3:05:00 PM] 19. The estimated total turnover for the year in which application is submitted : 20. Amount of registration fee paid with particulars of challan number and date, cheque number and date, name of treasury, bank etc. : DECLARATION I, ______________________________________________________________ son/daughter/wife of ____________________________________________________________ hereby declare that to the best of my knowledge and belief the information in this application give above is true and correct. Place: Name, address and signature of the person signing with the status and relationship to Date: the dealer, (Here state whether proprietor, manager, director, partner etc.) Note: 1. On every additional sheet of paper used indicate the Registration Certificate Number with division, Circle and Unit number. Also indicate the serial number of the information to which it pertains. 2. Write the page number of each additional sheet attached to this form starting from page number 9. 3. Total number of pages enclosed. 4. The date by which the registration certificate is ready ___________________________________ http://www.esevaonline.com/htmlpages/Forms/Apgst/form_d.htm (11 of 19) [7/1/2008 3:05:00 PM] (FOR OFFICIAL USE BY THE REGISTERING AUTHORITY) 1. Date of receipt of application __________________________________________ 2. Nature of order passed by the Registering Authority in the application __________________________________________ 3. Date on which, the place at which and the officer before whom the applicant is called Date ______________________________________ for verification of accounts. Place _____________________________________ 5. Registration Certificate number and date of Division ___________________________________ issue Circle: ______________________________ Unit Number _______________________________ Date _____________________________________ 6. Old number (if any in red ink) Division________________________________ Circle_____________________________________ Unit Number _______________________________ Date______________________________________ 7. No. of branches __________________________________________ 8. No. of godowns __________________________________________ 9. No. of Partners __________________________________________ 10. No. of Commodities __________________________________________ http://www.esevaonline.com/htmlpages/Forms/Apgst/form_d.htm (12 of 19) [7/1/2008 3:05:00 PM] FORM D Application for Registration as a Dealer under Section 12 of The Andhra Pradesh General Sales Tax Act 11. General category of business (See list __________________________________________ of codes supplied) SIGNATURE OF THE REGISTERING AUTHORITY Additional Sheets for Sl.Nos _______________ Name _________________________ Address ________________________ Building Name _________________________ Building Number____________________________ Ward Name _________________________ Ward Number ______________________________ Street / Road _________________________ Village / Town _________________________ STATE____________________________________ District _________________________ Pin code___________________________________ Name _________________________ Address _________________________ Building Name _________________________ Building Number ____________________________ Ward Name _________________________ Ward Number ______________________________ Street / Road _________________________ Village / Town _________________________ STATE____________________________________ District _________________________ Pin code___________________________________ Name _________________________ Address _________________________ Building Name _________________________ Ward Name _________________________ Street / Road _________________________ Village / Town _________________________ District _________________________ Additional Sheets for Point Nos_______________ Name _________________________ Address __________________________ Building Name _________________________ Ward Name _________________________ Street / Road _________________________ Village / Town _________________________ District _________________________ Name _________________________ Address _________________________ Building Name _________________________ Ward Name _________________________ Street / Road _________________________ Village / Town _________________________ Building Number ____________________________ Ward Number ______________________________ STATE____________________________________ Pin code___________________________________ Building Number____________________________ Ward Number ______________________________ STATE____________________________________ Pin code___________________________________ Building Number ____________________________ Ward Number ______________________________ STATE____________________________________ Name _________________________ Address _________________________ Building Name _________________________ Building Number ____________________________ Ward Name _________________________ Ward Number ______________________________ Street / Road _________________________ Village / Town _________________________ STATE____________________________________ District _________________________ Pin code___________________________________ Additional Sheet for Point No.5: Aditional Sheet for Point.No.9 Additional Sheet for point No.14( )