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FORM VAT- IV

[See rule 6(7) of the Goa Value Added Tax Rules, 2005]


Return of Sales and Composition Tax Payable by dealer opting for composition for the quarter ended

DD MM YYYY
          

Period from

DD MM YYYY
          
to

 
DD MM YYYY
          
(1) TIN:-

           
Valid upto
DD MM YYYY
          


(2)Name of the Dealer
_______________________________________

(3)Address of the Dealer
_______________________________________

(4)Style of Business
_______________________________________

(5)Nature of Business
_______________________________________

(6)Total turnover of Sales received and receivable during the period
:Rs.____________________________________

(7)Amount of Composition Tax payable.
:Rs.____________________________________

(8)Amount of Composition Tax paid
:Rs.____________________________________

(9)Number and date of receipted copy of chalan under which payment is made, attached to this return in proof of payment.
_______________________________________

(10) Details of Bank Account (only the changes in the Bank Account, if any, during the return period to be reported.)


DECLARATION


I Shri/Smt___________________of M/s _______________________do solemnly declare that the particulars disclosed in this return are true to the best of my knowledge and belief and that I / we have not been covered under any of the contingencies stated in sub-rule(7) of Rule 6 during the period covered under this return.


Place:
____________________

Date:
(Signature of the dealer)


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Commissioner of Commercial Taxes, Vikrikar Bhavan, MG Road, Panjim, Goa, India. Ph.:0832-2229225
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