| 1 |
Name and full postal address of the applicant (if there is atrade name, the trade name shall also be given).
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| 2 |
Name and address of the Manager of the business, if a Managerhas been so appointed.
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| 3 |
Name and address and status of the person who signs thisapplication (as regards status, state whether proprietor,manager, director or partner etc.)
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| 4 |
Name and full postal address of the Head Office withparticulars of building name and number, ward name and number,road name, street name etc. Give Telephone number, Fax number,e-mail address, Internet site address, if any.
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| 5 |
Name and full postal address of all the other places ofbusiness in the municipal area or elsewhere in the State withparticulars of building name and number, ward name and number,road name, street name etc., for each place of business (if thespace in this column is found to be insufficient, additionalsheet may be used and duly signed.)
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| 6 |
Complete list of godowns in which the goods are stored andaddress of every such godown.
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| 7 |
Date of commencement of business and nature of business. |
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| 8 |
Date on which applicant has become liable to pay tax for thefirst time.
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| 9 |
Particulars of Registration Certificate under the HaryanaValue Added Tax Act, 2003.
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(i) Tax payer's Identification Number. |
| (ii) Date of validity. |
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| 10 |
Estimated annual tax liability under the Act. |
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| 11 |
The accounting year followed by the applicant. |
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| 12 |
Whether the applicant is a proprietor, firm, company,society, club, association of persons, Hindu undivided family,or trust etc. (here give full description.)
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| 13 |
The total value of purchases/stock receipts of goods in theyear preceding that to which the application is submitted.
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| 14 |
Actual value of purchases/stock receipts of goods in the yearupto the date of submission of the application.
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| 15 |
Amount of registration fee paid with particulars of ReceiptNo. and date.
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| 16 |
Amount of fee paid for copies of certificate for the otherplaces of business with particulars of receipts No. and date,challan No. and date, cheque No. and date/name of theTreasury/Bank etc.
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| 17 |
Name (s) and address(es) of the proprietors, partners,members, all persons having any interest in the business(additional sheets with the following columns shall be used, ifnecessary.)
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