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6. 6A. 7. a-
Taxpayer's Identification Number [TIN] Taxpayer's PAN Details of Purchase [in Rs.] Vat Goods i. Purchase in own a/c against tax invoice (annexure-A Part -I) ii. iii. iv. v.
Purchase in own a/c from person other than registered dealer Purchase of exempted goods Purchase from Ex.U.P. 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 Any other purchase Total Less - purchase return (Annexure A-1) Net amount of purchase
Nil Nil Nil Nil 5,41,555 Nil 541555 Nil Nil Nil Nil Nil Nil Nil
Non Vat Goods i. Purchase from registered dealers ii. iii. iv. v. Purchase from person oher than registered dealer Purchase of exempted goods Purchase from Ex.U.P. Purchase in Principal's A/c (a) U.P. Principal (b) Ex. U.P. Principal Any other purchase Total vii. viii. Less - purchase return (Annexure A-1) Net amount of purchase Grand Total
vi.
c- Capital goods purchased from within the state i ii Purchase against tax invoice (Annexue A - 2 ) Purchase from person other than registered dealer
Total :0 0 0
Purchase through commission agent for which certificate in form VI has been received Sl.No. Certificate No. Date
Total :-
7A. Purchases / Value of goods received from outside state against Forms of declaration / certificates (a) (b) Purchase against Form C / Form H / Form I (Details to be furnished in annexure C, E & F respectively) Value of goods received from outside State against Form F (Details to be furnished in annexure D) Total :Commodity
--05000004 0 0 0
8.
Computation of tax on purchase Sl.No Rate of tax Vat Goods i. ii. iii. iv v vi. vii. viii. 1% 4% 12.5 % Additional Tax 0.5 % 1% 2% 3% 5%
Turnover of Purchase
Nil Nil Nil 0 0 0 0 0 Nil Nil Nil Nil Nil
Tax
Nil Nil Nil 0 0 0 0 0 Nil Nil Nil Nil Nil Nil Nil
Total Non Vat Goods ix. x. xi. xii. xiii. 20 % 21 % 26 % 32.5 % --Total Grand Total 9. aDetails of Sale Vat Goods i. Turnover of sale in own a/c against tax invoice (annexure-B Part - I) ii. iii. iv. Turnover of sale in own a/c other than in column- i. Turnover of sale of exempted goods Sales in Principal's 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 Interstate sale against form 'C' Interstate sale without form 'C' Sale in course of export out of India Sale in course of import Sale outside state Consignment sale / Stock Transfer Any other sale Total xii. xiii. Less : sales return (Annexure B - 1) Net Amount of Sales
-----
Nil Nil
Nil Nil Nil 2,32,708 Nil Nil Nil Nil Nil Nil 4,02,108 Nil 402108
b-
Non Vat Goods i. ii. iii. iv. Taxable turnover of sale Exempted turnover of sale Tax paid turnover of goods Sale in Principal's A/c (a) U.P. Principal (b) Ex. U.P. Principal Any other sale Total vi. vii. Less - saels return (Annexure B-1) Net amount of sales Grand Total
Nil Nil Nil Nil Nil 0 4,02,108 Nil Nil Nil
v.
Sales through commission agent for which certificate in form V has been received Sl.No. Certificate No. Date
Total :-
10.
Computation of tax on sale Sl.No i. ii. iii. i. ii. iii. iv. v. Rate of tax Vat Goods 1% 4% 12.5 % Additional Tax 0.5 % 1% 2% 3% 5% Total Non Vat Goods i. ii. iii. iv. v. 20 % 21 % 26 % 32.5 % --Total [VAT and Non Vat] Grand Total
Nil 1,69,400 Nil 8,470 Nil 0 0 8,470 Nil 0 ----Nil Nil Nil Nil Nil Nil Nil Nil -2C183001 -Nil 1,69,400 Nil 0 1,69,400 0 0 0 1,69,400 Nil 6,776 Nil 0 1,694 0 0 0 8,470
Commodity
Turnover of Sale
Tax
Installment of compounding scheme, if any Amount of T.D.S. Tax Payable [in rupees] i. ii. iii. iv. Tax on purchase Tax on sale. Installment of compounding scheme, if any T.D.S. amount Total
8,470
14.
Detail of ITC i. ii. ITC brought forward from previous tax period ITC earned during the tax period (a) On purchase made in own account (b) On purchases made through purchasing commission agent against certificate form VI Total :6,641.31 18118.73 0 18118.73
15.
(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 iii. Net tax Detail of tax deposited A- Name of the bank / branch B- By adjustment against adjustment vouchers Adjustment Vouchres Number T.C. number Date Date
Total :-
8,470 8,470 0
16.
0.00
Annexure-1 -Annexure A/ A-1/ A-2/B/B-1 whichever is applicable Treasury Challan number / date . I
DECLARATION ATUL MITTAL S/o, D/o, W/o PARMANAD MITTAL Status PROP. [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 : Place : 20-07-2012 Ghaziabad
Part - I
Taxable value of goods
12,125
Code
2C1520 01
Quantity / Measure
1 POONAM
SPECIALITY PRODUCTS C-223/3 SITE 1 BSR INDL AREA, GHAZIABAD, 0 - UTTAR PRADESH SHIVA ENTERPRISES 176, MALIWARA GHAZIABAD, UTTARPRADE SH - 201001 GAURAV ENTERPRISES KHASRA NO.33 GALI NO1, HINDON VIHAR GHAZIABAD, 0 - UTTAR PRADESH SAHNI POLYCHEM 45 HINDAN VIHAR GHAZIABAD, 0 - UTTAR PRADESH SAHNI POLYCHEM 45 HINDAN VIHAR GHAZIABAD, 0 - UTTAR PRADESH GAURAV ENTERPRISES KHASRA NO.33 GALI NO1, HINDON VIHAR GHAZIABAD, 0 - UTTAR PRADESH
0988910065 1
01
35
0979090046 3
04
07-04-20 12
FIBERG LASS
2C1830 01
306.3
32,774
1,638.7
34,412.7
0998881193 8
08
16-04-20 12
HARDN ER
2C1520 01
39.6
7,032
351.6
7,383.6
0918881603 5
01
20-04-20 12
RESIN
2C1450 01
675
78,975
3,948.75
82,923.75
0918881603 5
21
04-06-20 12
RESIN
2C1450 01
450
53,100
2,655
55,755
0998881193 8
44
07-06-20 12
HARDN ER
2C1520 01
30
4,200
210
4,410
7 HAMRAJ
ENTERPRISES E-5 SEC-11 PRATAP VIHAR GHAZIABAD, 0 - UTTAR PRADESH 8 SAHNI POLYCHEM 45 HINDAN VIHAR GHAZIABAD, 0 - UTTAR PRADESH 9 SAHNI POLYCHEM 45 HINDAN VIHAR GHAZIABAD, 0 - UTTAR PRADESH 10 GHAZIABAD POLYMERS (P) LTD C-136, SITE 1 BSR INDL AREA GHAZIABAD, 0 - UTTAR PRADESH
0968881539 6
80
15-06-20 12
0500000 4
8,118
1,095.93
9,213.93
0918881603 5
26
19-06-20 12
FIBERG LASS
2C1830 01
300
6,900
345
7,245
0918881603 5
28
25-06-20 12
RESIN
2C1450 01
225
26,550
1,327.5
27,877.5
0949080040 8
150
30-06-20 12
RESIN
2C1450 01
880
1,18,800
5,940
1,24,740
Total
3,48,574
18,118.73
3,66,692.73
Part - II
Taxable value of goods Amount Total of tax amount of charged tax-invoice
1
Total
Date
20-07-2012
(iv)
TIN
1 1
Total
Quantity / Measure
Total (8+9)
10
Quantity / Measure
Total (12+13) 14
Date 16
Date 18
11
Total
(v) Taxable amount of goods returned which were purchased against Tax invoice (vi) Amount of Tax involved in such goods
A - List of purchases of Capital goods made against tax invoice Name and TIN Tax Date of address invoice No Tax of selling dealer invoice 1 Total
B - List of purchase of Capital goods made from person other than registered dealer Purchase Date of Description of commodity invoice No Purchase Quantity / Name invoice
Measure
1
Total :-
Date
20-07-2012
Part - I
Taxable value of goods
3,000
Code
2C1830 01
Quantity / Measure
1 SHARMA SONS SACOVA INSTRUMENT S PVT. LTD. E-175 INDL. AREA, KAVI NAGAR GHAZIABAD, 0 - UTTAR PRADESH 2 R.K. CHEMICAL INDUSTRIES 26-A DHAULANA INDL AREA HAPUR, UTTAR PRADESH - 0 3 ENNOV INFRA SOLUTIONS PVT. LTD 61-B, UDYOG VIHAR GREATER NOIDA NOIDA, 0 - UTTAR PRADESH 4 SHARMA SONS SACOVA INSTRUMENT S PVT. LTD. E-175 INDL. AREA, KAVI NAGAR GHAZIABAD, 0 - UTTAR PRADESH
0979050022 9
10
0948920158 6
21-04-20 12
2C1830 01
3,000
150
3,150
0946570603 9
28-04-20 12
2C1830 01
46
18,400
920
19,320
0979050022 9
02-05-20 12
2C1830 01
11
16,500
825
17,325
5 ENNOV INFRA SOLUTIONS PVT. LTD 61-B, UDYOG VIHAR GREATER NOIDA NOIDA, 0 - UTTAR PRADESH 6 SHARMA SONS SACOVA INSTRUMENT S PVT. LTD. E-175 INDL. AREA, KAVI NAGAR GHAZIABAD, 0 - UTTAR PRADESH 7 ENNOV INFRA SOLUTIONS PVT. LTD 61-B, UDYOG VIHAR GREATER NOIDA NOIDA, 0 - UTTAR PRADESH
Total
0946570603 9
25-05-20 12
2C1830 01
150
60,000
3,000
63,000
0979050022 9
10-06-20 12
2C1830 01
8,500
425
8,925
0946570603 9
10
14-06-20 12
2C1830 01
150
60,000
3,000
63,000
1,69,400
8,470
1,77,870
Part - II
Taxable value of goods Amount of tax charged Total amount of tax-invoice
TIN
Tax invoice No
Date
20-07-2012
(iv)
1 1
Total
TIN
Quantity / Measure
Total (8+9)
10
Quantity / Measure
Total (12+13) 14
Date 16
Date 18
11
Total
(v) Taxable amount of goods returned which were sold against Tax invoice (vi) Amount of Tax charged in such goods
Name of seller 2
TIN 3
Address 4
State 5
Invoice No. 8
Description of goods 10
Taxable Amount
CST
Form - 38 No.
11
12
14
ATUL MITTAL
Name and signature of authorised person Date
20-07-2012
1 1
Quantity or weight
Value of goods
9
Total
10
Name of Railway Station/ Post office/ Airport/ Transport Co.'s office from which the goods were dispatched 11
Details of RR/GR/Postal receipt any other document indicating the means of transport No. Date 12 13
ATUL MITTAL
Name and signature of authorised person Date 20-07-2012
1
Total
11
Value
Details of consignment note/ bill of lading/ railway receipt or any other document in proof of export No. 17 Date 18
Description of goods
12
Total
13
14
15
16
19
20
21
Annexure - F
1
Total
10
11
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