FORM A6 Statement of Monthly Return FORM A6 Statement of Monthly Return (See Rule 17F of A.P.G.S.T. Rules, 1957) To The Deputy Commercial Tax officer I __________________________________________________________________________ Son of ________________________________________________________________________ working as ___________________________________ in the _________________________________________ Department of Government furnish herewith Statements of total and taxable turnover in respect of the sales effected by the Department for the month of ________________________________________. 1. Name of the Officer of the Department : 2. Designation of the Officer : 3. Name of the Department : 4. Address of the Office : 5. Particulars of payment (a) Total Tax payable : (b) Tax Paid : (i) Cheque/DD particulars http://esevaonline.com/htmlpages/Forms/Apgst/form_a6.htm (1 of 3) [6/9/2008 4:36:04 PM] FORM A6 Statement of Monthly Return Number : Date : Bank : Branch : (ii) Cash(Receipt number if paid) Receipt No. : Date : (iii) Challan Particulars Number : Date : Name of Treasury : (c) Balance payable, if any (a)-(b) : Statement of Commodity-wise tax and Turnover details No. of Commodities for Which Particulars are given Commodity Total Turnover Exempted Net Turnover Total Amount Tax Balance Turnover Tax due of tax provisionally due collected paid Description (1) (2) (3) (4) (5) (6) (7) (8) (9) Particulars of payment of balance due (10) Amount Rs. Cheque/ D.D.No.& Date ChallanNo. and Date Treasury http://esevaonline.com/htmlpages/Forms/Apgst/form_a6.htm (2 of 3) [6/9/2008 4:36:04 PM] DECLARATION : I, _______________________________________________________ Son/Daughter/Wife of __________________________________________________ declare that, to the best of my knowledge and belief, the information furnished in the above Statement is true and complete. Place : Signature ________________________________ Date : Status and Relationship to the dealer _____________________ Name (in block letters) __________________________ http://esevaonline.com/htmlpages/Forms/Apgst/form_a6.htm (3 of 3) [6/9/2008 4:36:04 PM]
