FORM 6 [See rule 7(1)] Application for cancellation of registration under Section 9 (5) of the Goa Tax on Luxuries Act, 1988. To, The Registration Authority, .............. .............. *I, ................ Who am/ * I .......... on behalf of .............( here state the name of registration hotelier) who is carrying on the business known as ........ holding a certificate of registration bearing number ......... under the Goa Tax on Luxuries Act, 1988 whose *only/ *chief place of business in the district of ......... is situated at (full address) ........ post office .... hereby apply for the cancellation of the said certificate of registration under the rule 7 of the Goa Tax on Luxuries Rules, 1988 on account of *(a) the said business having been discontinued with effect from .... *(b) the said business having been transferred in accordance with the section 8(4) with effect from ..... *(c) the following change having been effected in the ownership of the said business, with effect from .....*(d) the said business having been disposed of wholly as under with effect from ...... *(e) the additional place of business having been discontinued with effect from .... *(f) the place of business having been shifted to the following address, with effect from ...... *(g) the following other reasons:- ....... ........ My present address is as under: ........ ........ I, ......... do hereby declare that what is stated herein is true to the best of my knowledge and belief. Place ..... Signature: Date ...... Status ......... * Strike out whichever phrase/ clause is not applicable. * To be signed by the hotelier any person duly authorized him. ACKNOWLEDGMENT Received an application in form-6 signed by Shri ....... Dated ........ for cancellation of certificate of registration. No. .... Dated. ...... Serial No. ..... Receiving Officer
