Download Form of Declaration to be issued by Transferor

Form D-IV Sl No.: Form of declaration to be issued by Transferor under the Bihar Value Added Tax Ordinance, 2005. [See Rule 12(5)] COUNTERFOIL Name of Issuing dealer ............................................................................................................................................. along with his TIN ....................................................... To, ............................................................................................................. (Transferee). Taxpayer Identification No. ................................................................. 1. Certified that goods transferred by me/us as per details below are inputs purchased by me from inside the state of Bihar. Quantity and/or Weight .................................. Value of Goods ........................................................ Challan No. ......................................... and date ......................................... under which the goods were sent. Mode of Transport ............................................................... Vehicle No. ........................................................... No. and date of RR or Lorry Challan or any other document indicating means of transport ................................................. 2. Certified also that I have paid tax amounting to Rs. .................................... (Rupees ...................................................................................) at the time of purchase of aforementioned good from M/s ................................................................................... bearing Taxpayers Identification No. ................................................... The above statements are true to the best of my knowledge and belief. Dated ............................... Signature Status ...................................................................... Name of the person signing the declation with status ............................................................................. Note: To be given to the Transferee. Signature Status ...................................................................... Form D-IV Sl No.: Form of declaration to be issued by Transferor under the Bihar Value Added Tax Ordinance, 2005. [See Rule 12(5)] ORIGINAL Name of Issuing dealer ............................................................................................................................................. along with his TIN ....................................................... To, ............................................................................................................. (Transferee). Taxpayer Identification No. ................................................................. 1. Certified that goods transferred by me/us as per details below are inputs purchased by me from inside the state of Bihar. Quantity and/or Weight .................................. Value of Goods ........................................................ Challan No. ......................................... and date ......................................... under which the goods were sent. Mode of Transport ............................................................... Vehicle No. ........................................................... No. and date of RR or Lorry Challan or any other document indicating means of transport ................................................. 2. Certified also that I have paid tax amounting to Rs. .................................... (Rupees ...................................................................................) at the time of purchase of aforementioned good from M/s ................................................................................... bearing Taxpayers Identification No. ................................................... The above statements are true to the best of my knowledge and belief. Dated ............................... Signature Status ...................................................................... Name of the person signing the declation with status ............................................................................. Note: To be given to the Transferee. Signature Status ...................................................................... Form D-IV Sl No.: Form of declaration to be issued by Transferor under the Bihar Value Added Tax Ordinance, 2005. [See Rule 12(5)] DUPLICATE Name of Issuing dealer ............................................................................................................................................. along with his TIN ....................................................... To, ............................................................................................................. (Transferee). Taxpayer Identification No. ................................................................. 1. Certified that goods transferred by me/us as per details below are inputs purchased by me from inside the state of Bihar. Quantity and/or Weight .................................. Value of Goods ........................................................ Challan No. ......................................... and date ......................................... under which the goods were sent. Mode of Transport ............................................................... Vehicle No. ........................................................... No. and date of RR or Lorry Challan or any other document indicating means of transport ................................................. 2. Certified also that I have paid tax amounting to Rs. .................................... (Rupees ...................................................................................) at the time of purchase of aforementioned good from M/s ................................................................................... bearing Taxpayers Identification No. ................................................... The above statements are true to the best of my knowledge and belief. Dated ............................... Signature Status ...................................................................... Name of the person signing the declation with status ............................................................................. Note: To be given to the Transferee. Signature Status ...................................................................... * Strike out which is not applicable ** The declaration shall be signed by the proprietor of the business, if a proprietorship, karta if an undivided Hindu family; by an authorised partner, in the case of a firm; by the managing director, managing agent, or the principal executive officer, in the case of a company, by the principal executive officer or officer incharge in the case of a society, club or association, department or local authority, or by the manager, if any declared by one of these under section 22 of the Bihar Value Added Ordinance 2005. * Strike out which is not applicable ** The declaration shall be signed by the proprietor of the business, if a proprietorship, karta if an undivided Hindu family; by an authorised partner, in the case of a firm; by the managing director, managing agent, or the principal executive officer, in the case of a company, by the principal executive officer or officer incharge in the case of a society, club or association, department or local authority, or by the manager, if any declared by one of these under section 22 of the Bihar Value Added Ordinance 2005. * Strike out which is not applicable ** The declaration shall be signed by the proprietor of the business, if a proprietorship, karta if an undivided Hindu family; by an authorised partner, in the case of a firm; by the managing director, managing agent, or the principal executive officer, in the case of a company, by the principal executive officer or officer incharge in the case of a society, club or association, department or local authority, or by the manager, if any declared by one of these under section 22 of the Bihar Value Added Ordinance 2005.