FORM 'K' (See Rule 25 and 28) Application for the grant of exemption from entertainment tax under section 5(1)/5(3) of the Goa Entertainment Tax Act, 1964. 1. Name and address of the Institution/Club on behalf of which the application is made : 2. Whether the Institution/Organisation/Club is registered under Societies Registration Act, 1860. If so, give number and date of Registration : 3. Whether grant in aid is received from the Directorate of Sports and Cultural Affairs. If so, how much : 4. Aims and objects of the Institution / Organisation/Club : 5. Name and address of the President, Secretary of the Institution/Organisation/ Club : 6. Have you been granted exemption from entertainment tax in the past? If so, give details : 7. Have you rendered accounts to the Commissioner of Entertainment Tax in respect of the above exemptions? If so, when and if not, why? : 8. Particulars of the entertainment proposed to be performed: (a) nature of entertainment : (b) date on which and place where it is proposed to be performed as well as time. 9. Rates of admission proposed : 10. Approximate amount expected to be raised by sale of tickets thereof : 11. Specific purpose for which the sale proceeds are proposed to be utilized : 12. Name of the bank in which the sale proceeds are proposed to be deposited : 13. Whether there is written/printed/typed script for the performance? If so, please attach a copy : 14. The source from which the expenses in connection with the entertainment are proposed to be met. : Date:......... Signature of the Applicant (Name in block letters) Designation D E C L A R A T I O N I, .............................. President/Secretary of ........................ hereby affirm that the fact stated above are correct and that nothing has been concealed. I hereby undertake to produce the Commissioner of Entertainment Tax the accounts of the above mentioned performances within one month of the last date given in column 8(b). I have understood that if the accounts are not produced with the time limit mentioned above or the conditions subject to which exemption is granted are not fulfilled, I will be required to pay the entertainment tax on the above mentioned performances. Signature
