FORM VAT 41 [See Rule 40(2)] Certificate of deduction at Source by Awarder Counterfoil (To be retained by the awarder) Original (To be issued to the contractor) Duplicate (To be furnished to the issuing authority) Seal of issuing authority Form. No. :________________ Date of Issue: To Name of the Contractor _____________________________________ Registration No. (TIN) ______________________________________ Address _________________________________________________ I, __________________________ working as or holding post of ______ hereby certify that a sum of Rs. (in words) ___________________________ Rs. (in figures) __________@_______% in lieu of Value Added Tax has been deducted from Rs. _________ (bill amount) payable to you/credited to your account through voucher number _____________ on ________ (date) in respect of the contract. The particulars of contracts and deposits of the amount deducted there from at source are given below in the schedule. Date _________ Address of the awarder _____________________________________________ Signature & Seal of the person responsible for deduction and deposit of the tax. SCHEDULE Sl.No. Date of the contract Nature of the contract Gross value of the contract Bill No.& Date Amount of the bill Amount deducted at source Voucher No. and date of credit of payment to the contractor Gross amount of challan & date on which the tax deducted at source was deposited to the account of the Commercial Taxes Department Remarks 1 2 3 4 5 6 7 8 9 10 Date __________ Signature & Seal of the person responsible for deduction and deposit of the tax. VERIFICATION I, certify that the above statement is true, correct and complete and nothing has been omitted/ Concealed. Place _________ Date __________ Signature & Seal of the person responsible for deduction and deposit of the tax. (To be filled by issuing authority) The amount of Rs........................ deducted at source has been deposited into the Government treasury as under. Amount Date of deposit R.C.R. No. (if applicable) Signature of the Assistant Commissioner/Commercial Taxes Officer/Issuing Authority
