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FORM VAT- XXVII

[See rule 25(2) of the Goa Value Added Tax Rules, 2005]

QUARTERLY STATEMENT OF TAX DEDUCTED AT SOURCE FOR THE PERIOD

FROM _________TO __________

(1) Name and address of the Employer
:
 
(2) Registration number of the Employer
:
 
(3) TIN if any
:
 
(4) Total amount of payments made during
the quarter Rs. ____________________
chalan/scroll no..................... dtd..................
(5) Total amount of tax deducted at source Rs.
:
 
(6) Details of remittance
:
 
Sr. No.
Name & address of the contractor
TIN
Period
TDS Amount
     
* enclose separate statement if necessary


DECLARATION

I, ____________________do hereby solemnly declare that to the best of my knowledge and belief, the information furnished hereinabove is true and complete.

Place:


Date:



______________________________________
Signature of the employer or his representative
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