Industries Commissionerate Dist : ............................. An application for inclusion of new items in eligibility Certificate for Sales Tax incentives under scheme. (Read:-G.R. No:APN-102000-17(5)-I Dtd. 14.11.2000. 1 Name of the industrial undertaking (a) Office Address: (b) Factory Address: S.No./GIDC Plot No. Town Taluka Dist 2 Details of earlier Sales tax incentives availed (A) Scheme.. ... (B) Exemption/Deferment.. (C) Amount of E.C. (D) Period of E.C. (E) Reference No. & date of original E.C. with amendments etc. with copy of thereof for inclusion of new items. 3 Category of project: (A) SSI/Tiny/Medium & Large Unit OffOffOffOff (B) New/Ex pansion/Diversification OffOffOff (C) S.C./S.T./Women Entrepreneurs/on employed OffOffOffOff 4 Sales Tax No GST No. & Dt. CST No. & Dt. 5 Details of new products/items to be included in eligibility certificate. Item Code No Name of Scheme Eligibility Certificate No. & Dt. In which new items is to be included 7 8 9 10 11 New item are required to be added due to: (1)Addition of new Machinery Off (2) Technological up gradation Off (3) Change in process with existing/additional machinery Off (4) Any other details (pl. give brief) Off Whether new items require any Licences/permission etc. from any department? If yes give details of lic. (Such as Drug Lic./Explosive Lic./any other) Details of production (A) for new items (attach Separete sheet for product wise) (B) Please enclose first sale bill. permanent SSI No & Inclusion of items/Sia acknowledgement.. (please give copy of above inclusion) Details of G.P.C.B. consent (please enclose copy of air & water consent) Investment For original eligibility for which application is made (a) Land (b) Building (c) Other Construction (d) Plant & Machinery (a) Indigenous (b) Imported (e) Electrification (f) D.G. Set (g) Lab. Equip. (h) Pollution Control Equip. (i) Tech-know how fee (j) Social Infrastructure (k) Other (12) Details of Employment Local Outside % of Local employees Workers Supervisory Nonsupervisory Total Date...... ............ Place..... Signature of Applicant Designation: Seal N.B: Please give an............. as under) Undertaking 1 I/We undertake that all terms and conditions of the original certificate No & Date issued by the industries Commissionerate/DIC will be observed strictly. 2 This application is made for our new products namely. whthin the ceiling and operative period of the original certificate as stated above and we do not slaim for any additional investment or for any extension in the time limit already prescribed in the E.C. 3 The rate of Sales Tax applicable for the new items, is known to us and we will have to pay 25% of the applicable sales tax to the sales tx authority & 75% of the sales benefit will be availed by us within the total monitoning limit and operative period of the original E.C. 4 We undertake to pay regular sales tax and sales returns to the sales tax authority. 5 We undertake that we will not claim any sales tax benefit as soon as total limit of sales tax incentive is over or will not claim any sales tax incentive after expiry of operation period of the sales tax incentive. Date .... Signature of the Authority Place ... Company's Official Seal Checklist Enclosure: 1 Certified copy of PMT Registrtion and its inclusion Off Or IEM Acknowledgement with its inclusion of new item 2 G.P.C.B. consent for AIR & Water Off 3 First sale Bill for new item Off 4 Copy of Eligibility Certificate under which item is to be added. Off 5 Actual Employment Detail Off 6 Copy of GST/CST Registration OffOff 7 Manufacturing Process of new Product.
