ACKNOWLEDGEMENT

E Return Form III(E)

Transaction_id 5797846 Transaction_Date Apr 20, 2011
Sr Box No as Particulars detailes of Amount(Rs.)
No per Return
1 Box II Name of Dealer LAXOR SEATING
SYSTEM
2 Box I C.S.T. R.C. No./ TIN No. 27160627935C
3 Box I Type of Return Original
4 Box III Periodicity of Return Quarterly
5 Box III Period Covered by Return From:Jan 1, 2011
To :Mar 31, 2011
6 Box IV Gross turnover of sale 1542787.0
7 Box 6 Total Amount of C.S.T Payable 0.0
8 Box 7 Amount deffered ( out of Box ( 6) ( under package scheme of 0.0
incentives ) if any
9 Box 8 Balance Amount Payable 0.0
10 Box 9(a) a) Interest Payable 0.0
11 Box 9(b) b) Amount ofTax collected in excess of the tax payable if any ( As 0.0
per Box 5)
12 Box 10 Total Amount Payable 0.0
13 Box 10(a) Excess Credit brought forward from previous return 0.0
14 Box 10(b) Excess MVAT refund to be adjusted against the CST liability. 0.0
15 Box 10(c) Amount already paid 0.0
16 Box 10(d) Adjustment of Refund Avaialable as per Refund Adjustment order 0.0
Amount ( Details to be entered in Box 12 (d))
17 Box 11(a) Excess Credit carried forward to subsequent return 0.0
18 Box 11(b) Excess Credit claimed as refunt 0.0
19 Box 12 Balance Amount payable 0.0
Disclaimer :- This acknowledgement is generated from the information submitted in the return. It should not
be treated as the acceptance of claims made in the return.
Acknowledgement to be Submitted by the Dealer

Place
Date (Signature,Name and Designation of Authorised Person)