FORM 403

(See sub Rule (5) of Rule 51) SR. No. :

Declaration under section 68 of the Gujarat Value Added Tax Act, 2003
(For goods entering into the State from outside the)
To,
The Officer In charge,
Check post. …………….
(1) Place from which goods are dispatched :_________________________ District : ____________________
(2) Place to which goods are dispatched : ___________________________ District : ____________________
(3) Details of goods Invoice No. __________________________ Date ____________________
(4) Consignor’s details :

Name Registration
Certificate No.
& Date
Address

Telephone CST/LST/VAT
Registration
No. & Date
Fax
(5) Nature of Transaction :
: 1 : Inter State Sale : 2 : R.R. Endorsement : 3 : Depot Transfer
: 4 : Consign. to Branch / Agent : 5 : For Job works / Works contract : 6 : Any Other
(6) Consignee’s details :

Name State

Address GST / TIN

Registration No.
Date

Telephone CST
Registration No.
Fax Date

Consigned Values Rs. __________________________

S. No. Description of Goods Commodity Code Unit Quantity Rate of Tax Value

(7) Transporter’s: (a) Name _____________________________________________________

Details (b) Address _________________________________________________________________
(c) Owner / Partner’s Name __________________________ (d) Signature : ______________
(8) Vehicle No. : _______________________L. R. No. _____________________ Date ______________________
(9) Driver’s Detail (a) Name _____________________________________________________
(b) Address _________________________________________________________________
(c) Driving License No. ________________________________________________________
(d) License issuing State _______________________________________________________

(e) Driver’s Signature

(10) Name and Address of the person in charge of goods _______________________________________________

Place : _________________ Signature : X_________________________

Date : __________________ Designation : ________________________
For Commercial Tax Department / Check post
Entry No. Reason of abnormal Stoppage Result if any

Vehicle Date Time

Arrival

Depart

Date :____________________ Signature : _______________________ Designation : _______________________