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1. 2. 3. 4. 5. 6. 6A 7. a-
Assessment Year Tax Period Ending on Designation of Assessing Authority Name of Circle / Sector Name / address of the dealer -
- d d -
m m y y y y
Taxpayer's Identification Number [TIN] Taxpayer's PAN (Permanent Account Number ) Details of Purchase [in Rs.] Vat Goods i. Purchase in own a/c against tax invoice (annexure-A Part-I ) ii. Purchase in own a/c from person other than registered dealer iii. Purchase of exempted goods iv. Purchase from Ex U.P. v. Purchase in Principal's A/c (a) U.P. principal (a-i) Purchase against tax invoice (annexure-A Part-II ) (a-ii) Other purchases (b) Ex. U.P. principal vi. Any other purchase Total : vii. Less purchase return (annexure A-1) viii. Net amount of purchase Non Vat Goods i. Purchase from registered dealers ii. Purchase from person other than registered dealer iii. Purchase of exempted goods iv. Purchase from Ex U.P. v. Purchase in Principal's A/c (a) U.P. principal (b) Ex. U.P. principal vi. Any other purchase Total : vii. Less purchase return (annexure A-1) viii. Net amount of purchase Grand Total : Capital Goods purchased from within the State i Purchase against tax invoice (Annexure A-2) ii Purchase from person other than registered dealer Total :
b-
c-
d-
Purchases through commission agent for which certificate in form VI has been received Sl.No. Certificate No. Date value of goods purchased 1 2 3 Total :
7A.
Purchases/value of goods received from outside State against Forms of declaration / certificates (a) Purchase against Form C / Form H / Form I (Details to be furnished in annexure C, D & E respectively) (b) Value of goods received from outside State against Form F (details to be furnished in annexure F) Total : Computation of tax on purchase Sl.No. Rate of tax Vat Goods i. 1% ii. 4% iii. 12.5% Additional Tax iv. 0.5% v. 1% Non Vat Goods vi. vii. viii. ix. x. Total : Grand Total : Commodity Turnover of Purchase Tax
8.
Total :
9. a-
Details of Sale Vat Goods i. Turnover of sale in own a/c against tax invoice (annexure-B Part-I) ii. Turnover of sale in own a/c other than in column- i. iii. Turnover of sale of exempted goods iv. Sales in Principals A/C (a) U.P. principal (a-i) Sales against tax invoice (annexure-B Part-II ) (a-ii) Other sales (b) Ex. U.P. principal v. Interstate sale against form 'C' vi. Interstate sale without form 'C' vii. Sale in course of export out of India viii Sale in course of import ix. Sale outside state x. Consignment sale /Stock Transfer xi. Any other sale Total xii. Less sales return (annexureB-1) xiii. Net amount of sales
-2-
b-
Non Vat Goods i. Taxable turnover of sale ii. Exempted turnover of sale iii. Tax paid turnover of goods iv. Sale in Principal's A/c (a) U.P. principal (b) Ex. U.P. principal v. Any other sale Total : vi. vii Less sales return (annexure B-1) Net amount of sales Grand Total :
c-
Sales through commission agent for which certificate in form V has been received Sl.No. Certificate No. Date i. ii. iii. Total :
10.
Computation of tax on sale Sl.No. Rate of tax Vat Goods i. 1% ii. 4% iii. 12.5% Additional tax i. 0.5% ii. 1% Non Vat Goods i. ii. iii. iv. v.
Commodity
Sale amount
Tax
Total :
Total : [Vat and Non Vat] Grand Total : 11. 12. 13. Installment of compounding scheme, if any Amount of T.D.S. Tax Payable [in rupees] i. Tax on purchase ii. Tax on sale iii. Installment of compounding scheme, if any iv. T.D.S. amount Total : -
-3-
14.
Detail of ITC i. ITC brought forward from previous tax period ii. ITC earned during the tax period (a) On purchases made in own account (b) On purchases made through purchasing commission agent against certificate in form VI Total : (c) Installment of ITC on opening stock due in the tax period (d) Installment of ITC on capital goods due in the tax period Total : (e) ITC reversed during the tax period (f) Admissible ITC in the tax period (a+b+c+d-e) iii. (a) Adjustment of ITC against tax payable (b) Adjustment of ITC against CST iv. ITC carried forward to the next tax period, if any Total : Net tax i. Total tax payable (serial no. 13) ii ITC adjustment [14 (vii)] iii Net tax Detail of tax deposited A- Tax deposited in Bank / Treasury Name of the bank / branch T.C. number
15.
16.
Date
Amount of tax
Date
Amount of tax
In figures In words Annexure- 1 - Annexure A / A-1 / A-2 / B / B-1/C/D/E/F whichever is applicable. 2 - Treasury Challan number / date . DECLARATION I.S/o,D/o,W/o/.Status.[i.e. proprietor, director, partner etc. as provided in rule-32(6)], do hereby declare and verify that, to the best of my knowledge and belief all the statements and figures given in this return are true and complete and nothing has been willfully omitted or wrongly stated. Date Signature Place Status -
-4-
Annexure - A
(ii) (iii)
Part-I
Taxable value of goods Amount of tax charged. Total amount of taxinvoice
1 2 3 etc. Total :
Part-II
Taxable value of goods Amount of tax charged. Total amount of taxinvoice
1 2 3 etc. Total :
Annexure A-1
y Total (8+9)
10
Total :
Total : Quantity 11 VAT goods Taxable value of goods 12 Amount of Tax 13 Total (12+13) 14 Sl.no. of debit note issued 15 Date 16 Sl.no. of credit note received 17 Date 18
Total : (v) Taxable amount of goods returned which were purchased against Tax invoice (vi) Amount of Tax involved in such goods Rs Rs Name and signature of authorised person Date
-6-
Annexure A-2
(ii) (iii)
1 2 3 4 5 Total
B-List of purchases of Capital goods made from persons other than registered dealer
Description of commodity Name 1 2 3 4 5 Total Name and signature of authorised person Date Quantity / Measure Purchase invoice No. Date of Purchase invoice Taxable value of goods Amount of tax paid with return
-7-
Annexure - B
(ii) (iii)
Part-I
Taxable value of goods Amount of tax charged. Total amount of taxinvoice
1 2 3 etc. Total :
Part-II
Taxable value of goods Amount of tax charged. Total amount of taxinvoice
-8-
Annexure B-1
(ii) (iii)
10
Total :
Total : Taxable value of goods 12 Sl.no. of credit note issued 15 Sl.no. of debit note received 17
Amount of Tax 13
Total (12+13) 14
Date 16
Date 18
Total
(v) Taxable amount of goods returned which were sold against Tax invoice Rs (vi) Amount of Tax charged on such goods Rs
Name and signature of authorised person Date
-9-
Annexure - C
Taxable Amount
11
(Information to be furnished along with return of each tax-period in relation to purchases against Form-C) Sl. Name of No. the seller
1 2
TIN
Address
State
CST
12
1. 2. Total :
* Write 1 for resale, 2 for use in manufacture/ processing of goods for sale, 3 for mining, 4 for use in generation/ distribution of power, 5 for use in packing of goods for sale/resale and 6 for use in Telecommunication network.
Annexure - D
Details of RR/GR/Postal Date on which receipt any other the goods were document indicating the received by the means of transport transferee
(Information to be furnished along with return of each tax-period in relation to goods received from out side State against Form-F)
Sl. No. Name of the Consigner TIN Address State Details of challan / invoice/ other document under which the goods were sent Description of goods Quantity Value of Name of Railway or goods Station/ Post office/ weight Airport/ Transport Co.'s office from which the goods were dispatched
No. 1 1. 2. 2 3 4 5 6
Date 7 8
No. 12
Date 13 14
10
11
Total :
Name and signature of authorised person Date
- 10 -
Annexure - E
Quantity Value
(Information to be furnished along with return of each tax-period in relation to purchases against Form-H) Sl. Name of the No. Seller
1 1. 2. Total : 2
TIN
Address
State
Seller's bill/ Seller's Description Challan/ Cash bill/ Challan/ Cash of goods memo No. memo date
8 9 10
11
12
date
14
Name of airline/ Name of Airport/ Sea Details of consignment note/ port/ land customs Ship/ railway / goods bill of lading/ railway receipt station of export vehicle or other means or any other document in of export proof of export No Date
15 16 17 18
19
Total :
Annexure - F
Invoice / Challan date.
9
(Information to be furnished along with return of each tax-period in relation to purchases against Form-I) Sl. No.
1 1. 2.
TIN
3
Address
4
State
5
Purchase order no
6
Description of goods
10
Value of goods
11
Total :
Name and signature of authorised person Date - 11 -