Counter foil

Form VAT - 47
[See rule 53(1)]

DECLARATION FOR IMPORTS BY REGISTERED DEALER

[To be filled in ink]
Form No.
Name of the office of issue
Date of issue
Valid upto ..................

DD

MM

Seal of Issuing Authority

YYYY

To
The In-charge Check-Post
Declared and certified that the goods, particulars of which are given below, have been imported by me
/ us from outside the State for purposes mentioned in rule 53, and hold myself / ourselves liable for
payment of tax as per law to the Government.
Part -A (To be filled in by the Consignee)
1. Name of Consignor
Registration Number (TIN)
Address
Bldg. No/ Name/ Area
Town/City
District (State)
2. Name of Consignee
Registration Number (TIN)
3. Nature of the transaction- Tick appropriate box
For Consignment sale
Stock/Depot/Branch Transfer
Any other nature. Please Describe

Inter-State purchase

Declaration
I
,
(Proprietor/Partner/
Director/Karta/Business Manager) declare that the facts stated above in PART-A are true to the best of
my knowledge and belief and nothing has been concealed. I also undertake the responsibility to get
filled up PART-B from the consignor and PART- C from the Transporter.
Place:
Date:

Signature of Consignee
Name
Status with seal

PART B (To be filled in by the consignor or person authorised)

1. Invoice No. / Bill No./ dispatch memo No.
2. Date of. Invoice / Bill ./ dispatch memo (DD / MM / YYYY)
3. Value / estimated value of goods in Rs.(In figures)
(In words)
4. Name of Commodity
5. No, of Packages/ quantity
Place
Date

:
:

weight
Signature of Consignor or person authorised
Name
Status with seal

PART C (To be filled in by the Transporter)

1. Name and Address of the Transport Co.
2. GR (Bilty) No.& Date
3. Registration No. of the vehicle
Place
Date

:
:

Signature
Name
Status

Form VAT - 47
[See rule 53(1)]

DECLARATION FOR IMPORTS BY REGISTERED DEALER

1
2
3
4
5
6
7
8
9
10
11
12
13
14

[To be filled in ink]

Form No.
Name of the office of issue
Date of issue
Valid upto ..................

DD

MM

17
18

The In-charge Check-Post

Declared and certified that the goods, particulars of which are given below, have been imported by me
/ us from outside the State for purposes mentioned in rule 53, and hold myself / ourselves liable for
payment of tax as per law to the Government.
Part -A (To be filled in by the Consignee)

21
22
23
25

Registration Number (TIN)

Address
Bldg. No/ Name/ Area

Town/City

District (State)

2. Name of Consignee

Registration Number (TIN)

3. Nature of the transaction- Tick appropriate box
For Consignment sale
Stock/Depot/Branch Transfer
Any other nature. Please Describe

Place:
Date:

9
10

I
,
(Proprietor/Partner/
Director/Karta/Business Manager) declare that the facts stated above in PART-A are true to the best of
my knowledge and belief and nothing has been concealed. I also undertake the responsibility to get
filled up PART-B from the consignor and PART- C from the Transporter.
Signature of Consignee
Name
Status with seal

20
30
40
50

PART B (To be filled in by the consignor or person authorised)

60

1. Invoice No. / Bill No./ dispatch memo No.

2. Date of. Invoice / Bill ./ dispatch memo (DD / MM / YYYY)

70

3. Value / estimated value of goods in Rs.(In figures)

80

(In words)

90

4. Name of Commodity
5. No, of Packages/ quantity
Place
Date

:
:

100

weight
Signature of Consignor or person authorised
Name
Status with seal

PART C (To be filled in by the Transporter)

27

1. Name and Address of the Transport Co.

28

2. GR (Bilty) No.& Date

30

Inter-State purchase

Declaration

26

29

3. Registration No. of the vehicle

Place
Date

:
:

31
Punch Month of
Use

Signature
Name
Status

Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec

Above 100

24

1
3

1. Name of Consignor

19
20

YYYY

To

15
16

Seal of Issuing Authority

Punch Value upto Rs. in lacs

Duplicate/Original

Punch
Date
of
Use