FORM - 8 [See rules (11) and (13)] Luxury Tax R.C. No. Return-cum-Chalan of tax payable by a hotelier under the Goa Tax on Luxuries Act, 1988 (All figures should be rounded of to the nearest rupee) Name and full address of the hotelier . ... Luxury Tax R. C. No. G.S.T.R.C. No. if held . . . Period from . to . PART I Computation of turnover of receipt liable to tax 1. Total turnover of receipts of the hotelier during the period. (This should be calculated on the basis of tariff rates, given regard to section 5 (4) of the Act). Deduct:- (A)Turnover of receipts, where the charge for luxury provided in the hotel is less than one hundred rupees. (B)Turnover of receipts, on which tax is not payable on account (other than (A) above) of _________________ 2. Net turnover of receipts liable to tax PART II Calculation of tax payable 3. Calculation of tax - Sr. Categories of receipts, Tax Turnover of Deduction Balance tax payable No. which are the rate receipts under rule turnover of at the rate constituents of 15 receipts specified in turnover at Item No.2 liable to tax col. 2 (1) (2) (3) (4) (5) (6) (7) Where the charge for luxury is - 1. less than Rs.100/-Nil 2. Rs.100/- or more but does not exceed Rs.500/- per day 5% 3. exceeds Rs.500/-per day 10% Total (Net turnover as (Total tax payable) per Item No.2) PART III Amount payable/ refundable as per the return 4. Total tax payable as per Part-II Deduct:- Rs. .. (A) Amount credited under Refund Adjustment Order No. ..... dated ....... (B) Refund of Rs. ... Rs. .. due as per previous Rs. .. return for the period Rs. ... from ... to ... adjusted against tax payable in this return. (C) Amount paid by - Chalan No. ....., dated ....... Chalan No. ....., dated ....... (D) Total amount deducted on account of (A), (B) and (C) and above. 5. Net amount payable ..... 6. Net amount refundable, if any ..... 7. Interest under section 17 ..... 8. Penalty under section ..... .... 9. Amount payable/ refundable as per this return .... Amount paid with this Return-cum-Challan (in figures) ....... (in wards) ................... Amount paid in Cash/ by Cheque No. ......, dated .... of ..............Bank. The above statement is true to the best of my knowledge and belief. Place .... Signature .... Dated .... Status ...... For treasury use only Received Rs. ...... (Rupees ...................) (in figures) (in words) Date of entry ...... Challan No. ....... Treasurer/ Accountant, Treasury Officer/ Agent or Manager.