GOVERNMENT OF JHARKHAND COMMERCIAL TAXES DEPARTMENT [See Rule 44(1)(a)] Certificate of the Sale Proceeds by the Commission Agent to the Principal Serial Number: ________________________ Original/Duplicate Details of the Principal: 1. Name of the Dealer ___________________________________ 2. Registration No. (TIN) ___________________________________ 3. Address Building Name/Number ___________________________ Area/Road ___________________________ Locality/Market ___________________________ Pin Code ___________________________ Email Id ___________________________ Telephone Number(s) ___________________________ Fax Number(s) ___________________________ 4. Description of the goods sold: 1. Freight 2. Gaushala 3. Shifting charges 4. Weighing Charges 5. Delivery Charges 6. Labour Charges 7. Cartage 8. Other Charges Date Name of the goods Received vide VAT 38 (no.) & Date Quantity / No. of bags or packages Weight Rate unit per Amount Rs. Expenses Rs. Total : Commission : Grand Total : TOTAL Verification I certify that the information given in this form and its attachments (if any) is true and correct to the best of my knowledge and belief and nothing has been concealed Signature Full name of Applicant Designation Date Place
