FORM ST-39 [ See rule 40-B (2)] MONTHLY RETURN OF CLEARING, FORWARDING, TRAANSPORTING ETC. Name and address of the clearing/forwarding house/ Transporting agent etc................. The month for which the return relates.......... S. Date of Name and Name and No. and date No clearing full address full address of delivery forwarding of the of the note/way transporting consignor consignee bill etc. etc. 1 2 3 4 5 Description Quantity Value of Remarks Of goods _____________ goods No of Weight Packing 6 7 8 9 10 D E C L A R A T I O N I/We ............. Declare that to the best of my /our knowledge that the information furnished in the above return is true and correct and that it relates to the month of ......... Place Dated: Name and signature with status of the person signing.
