Punch Date of Use 1 2 3 4 5 6 7 8 9 10 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 11 JanPunch Month of Use Feb Mar Apr May Jun Jul Aug Sep Oct Nov P unch Value upto R s. in lacs 1 2 3 4 5 6 7 8 9 10 30 40 50 60 70 80 90 100 20 Dec A bove 100 Form VAT 49 [See Rule 54(1)] DECLARATION FOR CARRYING GOODS OUTSIDE THE STATE BY REGISTERED DEALER Original / Duplicate / Counter Foil To be filled in ink] Seal of Issuing Authority Form No. Name of the office of issue Date of issue Valid upto .................. D D M M YYYY To The In-charge Check-Post Certified that the goods, particulars of which are given below are sold / consigned by me to _________________________________________________ (place with State) for sale outside the State of Rajasthan or by way of branch transfers / depot transfers / stock transfers, or in the course of inter- State trade or commerce or by principal to outside agent or agent to outside principal and I /We hold myself /ourselves liable for payment of tax as per law 1. Name of Consignor Registration Number (TIN) Address Bldg. No/ Name/ Area Town/City District (State) 2. Name of Consignee Registration Number (TIN) Address of Consignee Bldg. No/ Name/ Area Town/City District (State) 3. Invoice No. / Bill No./ dispatch memo No. 4. Date of. Invoice / Bill ./ dispatch memo (DD / MM / YYYY) 5. Value / estimated value of goods in Rs.(In figures) (In words) 6. Name of Commodity 7. No, of Packages/ quantity weight 8. Name and Address of the Transport co. 9. Registration No. of the vehicle Declaration I , (Proprietor/Partner/ Director/Karta/Business Manager) here by declare that the facts stated above are true to the best of my knowledge and belief and nothing has been concealed. Place : Signature Date : Name : Status: Seal of the Consignor with VAT RC No(TIN) Verification I verify that the facts stated above are true to the best of my knowledge and belief and nothing has been concealed. Place : Signature Date : Name : Status :
