(See Rule 4)
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Return for the month / quarter
ending |
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| 1. | Name and address of the dealer |
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................................................................................................ .......................... .......................................................................................................................... |
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| 2. | Registration certificate number under the
Ordinance or the U. P. Trade Tax Act, 1948 |
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| 3. | Name of commodities brought in the local
area |
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Commodity |
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1 |
2 |
3 |
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| 4. | (a) Aggregate value of goods (commodity wise) |
Rs.............................. | Rs.............................. | Rs.............................. | ||
(b) Deduct value of goods on which tax has already
been paid |
Rs.............................. | Rs.............................. | Rs............................... | |||
| (c) Taxable value of goods | Rs.............................. | Rs.............................. | Rs.............................. | |||
| 5. | Tax payable | Rs. .................................................................... | ||||
| 6. | Tax realised | Rs. .................................................................... | ||||
| 7. | Tax paid | (1) Amount Rs. ................................................ | ||||
| (2) Challan No. ............................................... | ||||||
| (3) Date ........................................................... | ||||||
(4) Name of Bank ..........................................................................................
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Declaration
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I .................................................(full name) being the ........................................(status) of the business known as ..................................................................................................... .................do hereby declare and verify that to the best of my knowledge and belief all statements and figures given in this return are true and complete and nothing has been wrongfully omitted or wrongly stated. |
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Signature .......................................................... |
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Status ............................................................... |
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