GOVERNMENT OF JHARKHAND COMMERCIAL TAXES DEPARTMENT Application for Self-Assessment [ See Rule 31(1)] I hereby apply for Self-Assessment, for the Tax Period 05. For this purpose, I am enclosing the under-mentioned Informations / Documents / Forms I have filed the Annual Return on (state the receipt no. & if possible please attach the copy of the Annual Return) I have deposited all my Output Tax Payable (detail of payments enclosed) I have deposited all my Central Sales Tax Amount (detail of payments enclosed) I hereby enclose Form JVAT 400 (Wherever applicable) I hereby enclose Form JVAT 403 (Wherever applicable) I hereby enclose Form JVAT 404 (Wherever applicable) I hereby enclose Form JVAT 405 (Wherever applicable) I hereby enclose Form JVAT 409 (Wherever applicable) I hereby enclose Form JVAT 505 (Wherever applicable) I hereby enclose Form JVAT 506 (Wherever applicable) I hereby enclose Form JVAT 507 (Wherever applicable) I hereby enclose the statement of forms under the Central Sales Tax Act, i.e. Form 'C', Form 'D', Form 'F', Form 'E-I', Form 'E-II', Form 'H', Form 'I' (wherever applicable) I hereby enclose the Profit & Loss Account / Trading Account / Manufacturing Account (wherever applicable) I hereby enclose the statement of Purchases / Arrivals from outside the State under CST Act (wherever applicable) 01. Commercial Taxes Circle: FORM JVAT 124 02. TIN Date: 03. Name of the dealer 04. Nature of Business (X) whichever is applicable Manufacturer Miner Trader Works Contractor Others Receipt no. Published on National Portal of India (india.gov.in) To from Signature of the dealers Status Full name OFFICE USE ONLY Date of Application received Check Arrears of VAT Payments Confirmation from Returns filed - Tax Arrears, if any All Monthly Returns filed and Output Tax Paid (Please tick the appropriate or applicable) Annual Return Filed (Please tick the appropriate or applicable) All the statements showing therein are attached and are in order. If any extra tax / interest / penalty payable - such notice is issued All amount due / paid Prescribed Authority Circle/Sub-circle I hereby enclose the statement of Imports u/s 5(2) of the CST Act. I hereby enclose the statement of Exports u/s 5(1) and 5(3) of the CST Act. I hereby enclose the statement of Purchases from the registered dealers / unregistered dealers or from any other persons of the State along with the details of Tax Invoices received. I hereby enclose the statement of sales to the registered dealers / unregistered dealers / to any other person of the State along with the details of Tax Invoices issued. I hereby enclose the statement of the charges received towards non-taxable Heads (For works contractors only : Please tick the appropriate or applicable) I hereby enclose the statement the value of goods transferred in property. (For works contractors only : Please tick the appropriate or applicable) (Please tick the appropriate) Date Rs. /- Rs. /- Yes No Yes No Yes No Published on National Portal of India (india.gov.in) Yes No
