PRESS CTRL-P TO PRINT BACK FORM L.T. (DP)-I APPLICATION FORM FOR THE GRANT OR RENEWAL OF DEFERTMENT CERTIFICATE To The ........... ............ (The Assessing Authority) Sir, In accordance with the provisions of section 6-A of the Himachal Pradesh Tax on Luxuries (in Hotels and Lodging Houses) Act, 1979 and the Himachal Pradesh Tax on Luxuries (in Hotels and Lodging Houses) (Deferred Payment of Luxury Tax) Scheme, 1976, framed thereudner I, ..............(Name) aged ...... son of ....... Shri ............ resident of ............ Proprietor/ Partner/Managing Director/Manager............. of the new hotel as mentioned hereunder apply for the grant/renewal of certificate in Form L.T.(D.P.).-II and hereby declare as under:- (a) Name and complete M/s.......... address of the proprietor/ ............. Partner/Managing Director/ ............ Manager etc. of the new hotel ............ alongwith its registration Place.......... certificate No. under the Registration........ Himachal Pradesh Tax on Number ........ Luxuries (in Hotels and Lodging Houses) Act, 1979 with date of its Date of Validity ...... Validity ........... (b) Number with date of issue No.......... of the certificate in Form I. Date........... (c) Quantum of luxury tax deferment ............. http://hptax.nic.in/ltf10.htm 4/11/08 http://hptax.nic.in/ltf10.htm 4/11/08 applied for on the basis of ....(in words) certificate in Form I. ....(in figures) (d) Period of deferment subject to Years and months (in words). ceiling on quantum of luxury ............. tax to be deferred. From ....To....... (e) Description of new hotel, facilities and services provided therein: (i) the name of the hotel together with its location and branches, if any; (ii) what class of classes of accommodation is provided for monetary consideration; (iii) number of rooms available in each class of accommodation (iv) rent fixed room-wise under the Himachal Pradesh (Registration of Hotel and Travel Agent Act, 1988, if any; (v) Item of boarding provided to the visitor: a. bed tea, b. breakfast, c. lunch, d. evening tea, e. dinner, f. any other special item. (vi) charges of items mentioned in clauses (v) above when these http://hptax.nic.in/ltf10.htm 4/11/08 are sold to persons staying in Hotel. (vii) details of material served under clause (v) above (viii) charges of items mentioned in clause (v) when they are sold to persons other than those staying in the hotel. (ix) charges for : g. air conditioning h. telephone i. television j. radio k. music l. sports m. extra beds; and n. other amenities (x) concessional rates in relation to each class of luxury provided in the new hotel; (xi) charges for residence for which luxury tax is payable for rooms in each class of accommodation.; (xii) the script in which the accounts are kept. (f) Estimated gross turnover of charges for the current year under the Himachal Pradesh Tax on Luxuries (in Hotels and Lodging Houses) Act, 1979. Total turnover Rs........ (g) Amount of Luxury tax sought Amount Rs........ to be deferred under the Himachal ........... Pradesh Tax on Luxuries (in ........... Hotels and Lodging Houses) Act, 1979. (h) Notional Luxury Tax liability Amount Rs....... for he current year under the ............. Himachal Pradesh Tax on Luxuries (in Hotels and Lodging Houses) Act, 1979. (i) Basis of eligibility, whether: o. New hotel, (ii) Expansion, or (iii) Diversification ' ( In case of expansion or diversification give the following details of parent unit):- (i) Name and location of the new hotel (ii) Gross turnover of charges during the last year. 2. Attested copies of the following documents, contents of which are true and correct to the best of my knowledge, are hereby attached:- (i) certificate from Chartered Accountant regarding gross turnover of charges as on 31st day of March last; (ii) certificate from Chartered Accountant regarding the notional luxury tax liability for the current year; (iii) certificate from Chartered Accountant regarding fixed assets as on the 31st day of March last, wherever applicable; (iv) copy of balance sheet as on the 31st day of March last, duly certified by Chartered Accountant where-ever applicable; (v) copy of trading account and profit and loss account for he year ending the 31st day of March last duly attested by the Chartered Accountant in case of renewal of certificate; (vi) latest copy of change in the constitution/partnership deed/memorandum/ articles of association/bye-laws of the society etc. duly attested; (vii) copy of power of attorney or certified copy of resolution passed by Board of Directors/members authorising a particular person to apply for making deferred http://hptax.nic.in/ltf10.htm 4/11/08 payment of luxury tax. 3. (i) I hereby opt for availing the facility of making deferred payment of luxury tax. (ii) I hereby state that the unit satisfies all the conditions essential for the issuance of renewal of certificate in L.T.(D.P.)-II. (iii) I hereby undertake that I shall abide by the terms and conditions contained in the Himachal Pradesh Tax on Luxuries (in Hotels and Lodging Houses) (Deferred Payment of Luxury Tax) Scheme, 1996, and the provisions of the Himachal Pradesh Tax on Luxuries (in Hotels and Lodging Houses) Act, 1979, the rules framed and the notifications and orders issued thereunder. (iv) I hereby certify that the hotel in respect of which the facility of making deferred payment of luxury tax has been applied for is a 'new hotel' and has not been formed as a result of reestablishment, mere change of ownership, change in its constitution, re-construction of revival of an existing hotel. Signature of Applicant..... Name............. Status............. Date............. http://hptax.nic.in/ltf10.htm 4/11/08
