FORM 'B' (See Rule 18) Statement of tickets not being complimentary tickets issued when duty is payable under clause (a) or (b) of sub-section (2) of Section 4 Name and place of entertainment:................. Date of performance:........ Number and time of show Price of tickets including duty Number of tickets issued subject to tax Serial numbers of tickets issued Gross receipts Amount of tax payable to Government Remarks From To Rs. Rs. Date:... Signature of Proprietor