GOVERNMENT OF JHARKHAND FORM JVAT 100 COMMERCIAL TAXES DEPARTMENT APPLICATION FOR VAT REGISTRATION [See Rule 3(i) and 3(x)(a)] Information to be furnished by a dealer registered under the Adopted Bihar Finance Act, 1981 or a dealer whose Application submitted for Registration under the Act ibid, is pending. To The Registering Authority ......... Circle/SubCircle. I/We ............. Proprietor/Partner(s)/Karta of HUF/Principal Officer managing the business/affairs of the Company/Society/Association of Persons/Club/Head of the Department or any other officer duly authorised by him in writing, of the business, details of which are given below, hereby furnish the following information in respect of my business for the purpose of grant of registration certificate under subrule 3(i) of Jharkhand VAT Rules 06. 1. Name of the Dealer : 2. Registration Certificate Number under the Adopted Bihar Finance Act 1981 (PartI). 3. Registration Certificate Number under the Central Sales Tax Act 1956. 4. Date of Liability D D - MM - YY 5. Date of Validity 6. Date of submission of Application for grant of Registration under Jharkhand VAT Act 05, which is pending as on Appointed Day [See Rule 3(ii)]. 7. Principal Place of Business and contact number(s). 8. Permanent Account Number of the Dealer(s)/Business (PAN) 9. Constitution of the business (.) whichever is applicable 10. Nature of Business (.) whichever is applicable 11. (a) Principal Commodities in which the business deals in and Address Phone/Mobile : City Fax: District EMail: Proprietorship Public Limited Company Board or Corporation Government Department Partnership HUF Association of Persons Others Private Limited Company CoOperative Society Club Manufacturing Exporter Distributor Local Authority Mining Whole Sale Trade Stockist Importer Power Generation / Distribution Retail Trade C & F Agent Others Works Contractor Restaurant Govt. Company (b) The items codes therein 12. Details of Bank Account(s) Name of Bank with address Type of account Account Number 13. Details of immovable properties owned wholly or partly by the business. 14. Script in which account books are maintained. 15. State: whether your accounts are computerized : Yes / No (please tick) 16. The names, addresses and other details of the proprietor, each of the partner, Karta of HUF and each director (in case of private limited company) are attached as AnnexureI. 17. A copy of the partnership deed and Memorandum of Articles of Association is enclosed. 18. The details of additional place(s) of business/units/branches are attached as AnnexureII. 19. The details of security furnished are attached as AnnexureIII. FORM JVAT 100 20. The details of closing stock as on Appointed Day are attached in JVAT 114. 21. Passport size (self signed) photograph(s) of the proprietor, each of the partner, Karta of HUF and each director (in case of private limited company) is/are pasted below. Sr. No. Description of property Address where property is situated Approximate value Share Percentage FORM Name_____________ Status_____________ Status_____________ Status_____________ Name_____________ Name_____________ Name_____________ Status_____________ Status_____________ Status_____________ VERIFICATION I/We ______________________________ do hereby solemnly affirm and declare that the information contained in this application, including Annexures attached herewith, is true and correct to the best of my/our knowledge and belief. Signature ....... .... Place : Status........ ..... Date: Full Name ........ ..... DECLARATION FORM JVAT 100 (i) I/We hereby undertake to abide by the provisions of the Jharkhand Value Added Tax Act, 2005 and the Jharkhand Value Added Tax Rules, 2006. (ii) A signboard in the name of my/our business has already been displayed at all the business premises. (iii) That the books of accounts in respect of the said business are being maintained and shall be found at the said business premises. Place...... Signature Status........ ..... Date Full Name ........ ..... FORM JVAT 100 (Signature of other partners in case of partnership business) (1) Place.... Signature..... (2) Place.... Signature... ... Full Name ...... Full Name . ..... Date.... Status........ Date..... Status.......... (3) Place.... Signature..... (4) Place.... Signature... ... Full Name ...... Full Name . ..... Date.... Status........ Date..... Status.... ...... (For office use only) Acknowledgements receipt No. ...... Date ......... Circle ...... Signature and Stamp of Authorised Person