FORM 'E' (See Rule 24) Return of complimentary tickets Name and place of entertainment.......... Date of performance....... Class ofticket Rate ofticket Number of complimentary tickets issued Serial number of tickets issued Amount of tax payable to Government From To 1 2 3 4 5 Date:......... Signature of the Proprietor.......... ******* Government of Goa, Office of the Commissioner of Entertainment Tax, Panaji, Saka 190. ( ) No. CET/EXM/ To, 1. }* 2. }**