FORM ENT XI (See rule 19(2) ORDER OF ASSESSMENT /REASSESSMENT UNDER SECTION 6A /6C Goa Entertainment Tax Act, 1964 1 Registration Certificate No. Under (a) Goa Entertainment Tax Act 1964 (b) Goa VAT Act 2005 (TIN) (c) Goa Tax on Luxuries Act 1988 Period of Assessment 2 Name & Address of the Assessee Date Of Service Of Notice 3 Assessment of turnover liable for taxation (a) Total turnover for admission charges (b) Deductions (i) Total turnover for admission charges not exigible to tax (ii) Total turnover for admission charges exempt from tax u/s 5 of the Goa Entertainment Tax Act 1964 (iii) Others TOTAL DEDUCTIONS (i) to (iv) (c) TAXABLE TURNOVER (a) -(b) 4 Tax assessed as payable under Schedule A (For Cinema Halls & Theaters) Item TTO (Rs.) Rate Of Tax % Tax Payable (Rs.) Item TTO (Rs.) Rate Of Tax % Tax Payable (Rs.) 1(b) 30 3(d) (ii) 15 1 (c) 40 4 (a) (i) 10 2 30 4(a) (ii) 15 2 10 4 (b)(ii) 10 3(b) 10 4 (b) (iii) 15 3 (c) 20 TOTAL 5 Tax assessed as payable under Schedule B (For Cruise Operators) Item TTO (Rs.) Rate Of Tax % Tax Payable (Rs.) Item TTO (Rs.) Rate Of Tax % Tax Payable (Rs.) 1 15 2 10 TOTAL 6 Tax assessed as payable under Schedule C (For Cable Operators) Item TTO (no of Connectio ns) Tax Rs, per Connect ion Tax Payable (Rs.) Item Rate of Tax Tax Payable (Rs.) (i) 10 (iv) 5% (ii) 15 (iii) 10 TOTAL Rs....... (v) 20 7 Tax assessed as payable under Schedule D ( For Casinos) Item No. of PAX Rate Of Tax/ PAX Tax Payable (Rs.) Item TTO (Rs.) Rate Of Tax % Tax Payable (Rs.) 1(a) (i) 10/ PAX 1(b) 200 /PAX 1 (a) (ii) 200/ PAX 1(c) 10% Tax payable on lump sum basis for casino entry @ Rs.10/- per room per month TOTAL Rs. 8 TOTAL Tax Assessed (4+5+6+7 ) Rs. /- ( Rs.....................) 9 Tax Paid Challan No. Date 10 Balance to be paid 11 Interest Due 12 Penalty 13 Total Liability aseesed 14 Demand payable/ Refund due Seal Place Signature and Date
