"FORM VAT-36 [See rule 22 & 37] Certificate of the Sale Proceeds by the Commission Agent to the Principal Serial No. ______________ Counterfoil/Original/Duplicate Details of the Principal: 1. Name of the Dealer ____________________________________________ ____________________________________________ 2. Registration No. (TIN) _________________________________________ 3. Address Building __________________________ No./Name/Area Area/Road __________________________ Locality/Market __________________________ Pin Code __________________________ E-mail id __________________________ Telephone Number(s) __________________________ FAX Number(s) __________________________ 4. Description of the goods sold by Agent: VAT invoice Name of the goods Good received vide VAT35 Qt/No. of bags or packages Weight Rate Amount (Rs.) Expenses (Rs.) VAT No. Date No. Date (1) Freight (2) Gaushala (3) Shifting Charges (4) Weighing Charges (5) Delivery Charges (6) Labour Charges (7) Cartage (8) Other Charges Total: Commission: Grand Total: SIGNATURE Name: Status: Place Date VERIFICATION I/We verify that the information given in this form and on its attachment is true and correct to the best of my knowledge and belief and nothing has been concealed. SIGNATURE Name: Status: Place Date"