"FORM VAT-36A Certificate to be issued by the principal as a proof of deposit of tax to his agent [See rule 22 & 37] Serial No. ______________ Counterfoil/Original/Duplicate 1. Name of the Dealer 2. Address Building No./Name/Area Town/City District (State) Pin Code E-mail id Telephone Number(s) Fax No. 3. (a) Name of Agent (b) Registration No. (TIN) (c) Address (d) Building No./Name/Area (e) Town/City (f) District (State) (g) Pin Code E-mail id (h) Telephone Number(s) Fax No. 4. Description of the goods sold by commission agent: S.No. S.No. of VAT36 Date Sale proceeds (in Rs.) Accrual of tax liability (in Rs.) Discharge of tax liability (in Rs.) Date & ledger folio no. By claiming ITC, if applicable (in Rs.) By depositing tax amount (in Rs.) SIGNATURE Name: Status: VERIFICATION I/We verify that the sale proceeds shown in column no. 4 above have been recorded by me/us in our regular books of accounts and the tax liability accrued in the hands of commission agent has been discharged by me/us. SIGNATURE Name: Status: Place Date
