Form VAT- 04 [See Rule 15 (1)] Application for Issue of Duplicate Registration Certificate 2. Principal Place of Business Bldg. No/ Name/ Area Town/City District Pin Code Telephone Number(s) 3. Date of issue of original Registration Certificate 4. Date from which registered under Rajasthan Value Added Tax Act 5. Reason for applying for duplicate registration certificate as Original Registration Certificate is Misplaced Lost Destroyed Place: Signature Date: Name : Status : Verification I certify that the above information is true and correct to the best of my knowledge and belief and nothing has been concealed Place: Signature Date: Name : Status : Instructions: 1. Please read the instructions carefully 2. All the entries should be filled in capital letters 3. Tick . applicable in option boxes 4. The application should be filed in duplicate. 5. This Form should be verified and signed by. a. Proprietor, in case of Proprietorship concern. b. Managing Partner, in case of Partnership firm and where there is no Managing Partner, by all the partners if there is no registered partnership deed and in case of a registered partnership deed by any one of them. c. Managing Director or authorized signatory, in case of a Company. d. Karta, in case of Hindu Undivided Family. e. Authorised Signatory, in all other cases. 6. Enclose proof of payment of prescribed fee
