| 1 |
Name of Dealer |
|
| |
Whether Non Resident Dealer |
Yes / No |
| 2 |
(i) Address of Principal Place of Business |
|
| |
(ii) Bldg. No/Name/Area |
|
| |
(iii) Town/City |
|
| |
(iv) District (State) |
|
| |
(v) Pin Code |
|
| |
(vi) Email ID |
|
| |
(vii) Alternate Email ID (if any) |
|
| |
(viii) Mobile Number |
|
| |
(ix) Telephone Number(s) (if any) |
|
| |
(x) Fax No. (if any) |
|
| [3 |
Permanent Account Number (PAN) of Dealer, (Incase of Sole proprietorship, PAN allotted to proprietor bementioned)]
|
|
| 3A. [ |
Permanent Account Number (PAN) of the Dealer/Proprietor, (In case of Sole Proprietorship, PAN allotted toproprietor be mentioned]
|
|
| 4 |
Date of commencement of business |
D |
D |
M |
M |
Y |
Y |
| |
The Rajasthan Value Added Tax Act, 2003 |
D |
D |
M |
M |
Y |
Y |
| |
The Central Sales Tax Act, 1956 |
D |
D |
M |
M |
Y |
Y |
| |
The Rajasthan Tax on Entry of Goods into LocalAreas Act, 1999
|
D |
D |
M |
M |
Y |
Y |
| |
The Rajasthan Tax on Luxuries (in hotels andlodging houses) Act, 1990
|
|
| 5 |
Date from which liable to be registered. |
| |
The Rajasthan Value Added Tax Act, 2003 |
D |
D |
M |
M |
Y |
Y |
| |
The Central Sales Tax Act, 1956 |
D |
D |
M |
M |
Y |
Y |
| |
The Rajasthan Tax on Entry of Goods into LocalAreas Act, 1999
|
D |
D |
M |
M |
Y |
Y |
| |
The Rajasthan Tax on Luxuries (in hotels andlodging houses) Act, 1990
|
D |
D |
M |
M |
Y |
Y |
| 6 |
Actual Value of goods purchased, stock receiptof goods in the year up to the date of submission of theapplication. (To be filled by dealer who intends to getregistration under ETLA, 1999)
|
|
| 7 |
Whether opting for payment of tax u/s 3(2) |
Yes/No |
| |
If No, |
|
| |
(i) Whether intends to sale exempted goods |
Yes/No |
| |
(ii) Whether intends to opt to pay tax in lumpsum u/s 5
|
Yes/No If yes name of Composition Scheme(s) |
| |
(iii) Whether intends to sale goods taxable atfirst point in the series of sales and goods have suffered tax atthe said first point.
|
Yes/No If yes Commodity name of name of |
| |
(iv) Whether intends to sale goods taxable atmaximum retail price and such goods have suffered tax at maximumretail price.
|
Yes/No If yes Commodity |
| |
(v) Whether intends to opt for exemption in lieuof tax u/s 8(3)
|
Yes/No |
| |
(vi) Whether dealer also intends to sale goodsother than those mentioned above in (i) to (v)
|
Yes/No |
| 8 |
Nature of Business |
Manufacturer/Retailer/Leasing/Wholesaler/WorksContractor/Exporter/Other, please specify
|
| |
(i) If Manufacturer (As defined by sub-section(1) of section 7 of the Micro, Small and Medium EnterprisesDevelopment Act, 2006 )
|
Small/Medium Large |
| 9 |
Commodities dealt with/ proposed to be dealtwith
|
Intend To Purchase/Receive and Intend to Sale |
| 10 |
Constitution of Business: |
Proprietorship Partnership/Private Ltd.Company/Public Ltd. Company/Public SectorUndertaking/HUF/Co-operative Society/Club/Trust/Central/StateGovernment Department/ Others, Please specify
|
| 11 |
Particulars of the proprietor/partners/directors/Karta/Trustees/Members of the governing body/authorizedsignatory:
|
|
| |
(i) Full Name |
|
| |
(ii) Father's/Husband's Name |
|
| |
(iii) Date of Birth |
|
| |
(iv) Status |
|
| |
(v) Extent of interest % |
|
| |
(vi) Permanent address |
|
| |
(vii) Mobile No. |
|
| |
(viii) Telephone No. (if any) |
|
| |
(ix) PAN |
|
| |
(x) Email ID |
|
| |
(xi) Details (including address) of allimmovable property owned by or in which the person hasinterest/joint interest.
|
|
| |
(xii) Particulars of interest in any otherbusiness (es), if any
|
|
| |
a. Name of other business |
|
| |
b. Complete Address of other business |
|
| |
c. TIN |
|
| |
d. CST No. |
|
| |
e. Nature of interest in the business |
|
| |
f. Extent, of interest |
|
| |
(xii) Particulars of interest in any otherclosed business(es)
|
|
| |
a. Name of closed business |
|
| |
b. Complete Address of closed business |
|
| |
c. R.C.No. |
|
| |
d. Date of closure |
|
| |
e. Nature of interest in the business |
|
| |
f. Extent of interest Details of surety/securitybond:
|
|
| |
A In case of surety |
|
| |
I. Name of business, of I surety |
|
| |
TIN |
|
| |
II. Name of business of II surety |
|
| |
TIN |
|
| |
B. In case of security is furnished by cash/NSC,details thereof
|
| |
S.No. |
Amount |
No. |
Date of Maturity |
| |
1 |
|
|
|
| |
2 |
|
|
|
| |
3 |
|
|
|
| |
C. In case of security is furnished by BankGuarantee, details thereof
|
| |
1 |
Amount of Bank Guarantee |
|
|
| |
2 |
Effective Period of Bank Guarantee |
|
|
| |
3 |
Name of Bank and Address of Branch |
|
|
| 13 |
Information regarding Bank Account |
| |
1 |
Name of Bank |
| |
2 |
Name and Address of Branch |
| |
3 |
Account No. |
| |
4 |
Type of Account |
| |
5 |
IFSC of Branch |
| 14 |
Details of Branch(es)/Additional Place(s) ofbusiness including warehouse(s) in the State:
|
| |
Factory |
Godown/Warehouse |
Branch (es)/Additional Place (s) |
Other (place specify) |
| |
1. Bldg. No./ Name/ Area |
|
| 2 |
Town/City |
|
| |
3. District (State) |
|
| |
4. Pin Code |
|
| |
5. Email ID (if any) |
|
| |
6. Telephone Number (s) (if any) |
|
| |
7. FAX No. (if any) |
|
| 15 |
Details of Branch(es)/Additional Place(s) ofbusiness outside the State:
|
| |
1. Bldg. No./ Name/ Area |
|
| |
2. Town/City |
|
| |
3. District (State) |
|
| |
4. Pin Code |
|
| |
5. Email ID (if any) |
|
| |
6. Telephone Number (s) (if any) |
|
| |
7. FAX No. (if any) |
|
| 16 |
Details of business Manager(s) |
| |
1. Name of Business manager |
|
| |
2 Bldg. No./Name/Area |
|
| |
3. Town/City |
|
| |
4. District (State) |
|
| |
5. Pin Code |
|
| |
6. Email ID (if any) |
|
| |
7. Telephone Number(s) (if any) |
|
| |
8. FAX No. (if any) |
|
| |
To be furnished by a dealer opting forregistration under the CST Act, 1956
|
| 17 |
Type of Registration |
u/s 7(1) u/s7(2) |
| 18 |
Goods or class of goods to be purchased in thecourse of inter state trade or commerce
|
for resale, use in manufacture or processing ofgoods for sale, use in mining, use in generation or distributionof electricity or any other form of power, use in the packing ofgoods for sale/resale power.
|