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3- 4- 5- 6- 7- 8- 9- 10- 11- 12- 13- 14- 15- 16- 17- 18- 19- 20- 21- 22- 23- 24- 25- 26- 27- Name of th Receipt No Name and d 1- As 2- A Date - Place -

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Page 1: Microsoft Word - Form 26.doc - Views Exchange - · XLS file · Web view · 2014-06-04Any other Form - Annex the detail ... Total No. Closing Inventories of Opening & Closing Stock,

FORM - XXVIDepartment of Commercial Taxes, Government of Uttar Pradesh

[See Rule-45(7) of the UPVAT Rules, 2008 and Section 24 (7) & 26 of the UPVAT Act, 2008]Acknowledgement and self assessment of Annual Tax under Section 26 of the UPVAT Act, 2008

3-

4-

5-6-7-8-9-10-11-12-13-14-15-16-17-18-19-20-21-22-23-24-25-26-27-

Name of the dealer-

Receipt No. and date

Name and designation of official of the DCT

FORM - XXVIDepartment of Commercial Taxes, Government of Uttar Pradesh

[See Rule-45(7) of the UPVAT Rules, 2008 and Section 24 (7) & 26 of the UPVAT Act, 2008]Annual Tax Return

1- Assessment Year

2- Assessment Period beginning from

Date -

Place -

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ToThe Assessing Authority

Corporate circle/Sector…………………… District …………………………Sir,

I ------------------------------------------------- s/o,d/o,w/o ------------------------------- (status) --------------------------------- of

M/s ………………………………………………………………………… ........................................................ hereby,

submit the Annual Tax Return and furnish the particulars of business as follows :

1. Assessmen

2. Assessmen

Ending on

3.

4. Taxpayer's Identification Number [TIN]

6. S.N.

i ii iii

7.

S.N.iiiiiiivvviviiviiiixxxixii

- Annex the detail information in annexures (I - VII) whichever applicable

Inventories of Opening & Closing Stock, Purchase & Otherwise Receipts, Manufacturing and Sales of Goods inAnnexure (VIII to X)

9(a). Details of purchase (other than works contract and transfer of right to use of any goods)

5. Entitlement certificate no./date

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S.N.

i-ii-iii-iv-

v- vi-vii-

viii-

ix-ix-

Note: Reason to be given if the details of the purchases given here defer from those given in monthly and quarterly return

9(b). Computation of Tax on the turn over of purchase made from person other than registered dealer

S.N.i-

ii-iii-iv-v-vi-etc

10(a). Details of sales (other than works contract and transfer of right to use of any goods)

S.N.

i-ii-

iii-iii(a)iii(b)iii(c)Note: Reason to be given if the details of the sales given here defer from those given in monthly and quarterly return

10(b).S.N.

i-ii-iii-iv-v-vi-etc.

11- Total tax payableS.N.

iiiiiiiv

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vviviiviiiix

12-

S.N.

i-

ii-

iii-

iv-

v-

vi-

vii-

viii-

ix-

x-xi-

xii-

1-S.N. i ii

2-S.N. i

ii

14(a)- Details of deposit along with return of tax period in Treasury/Bank

13- Information regarding search & seizure:-

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S.N.1

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

14(b) -

S.N.

Page 4 of 14

14(c) - Details of TDS in Form XXXIS.N.

15 - Computation of Net tax payableS.N.1-2-3-4-5-6-7-8-

DECLARATION

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I……………………………….S/o,D/o,W/o/………………………………………Status……………………….[i.e. proprietor, director, partner etc. as provided in rule-32(6)], do hereby declare and verify that, all the statements andfigures given in this return are true and complete to the best of my knowledge and belief and nothing has been willfullyomitted, suppressed or wrongly stated.

Name of the dealer-Note:- 1-This Return must be signed by a person who is authorized under rule 32 (6) of Uttar Pradesh Value Added Tax Rules, 20082-if space provided in any table is insufficient the information may be submitted in prescribed format on separate sheet.

Department of Commercial Taxes, Government of Uttar Pradesh

Detail of Transport Memo in Form XXI received from the Department of Commercial Taxes and used in the assessment year

S. N.

Department of Commercial Taxes, Government of Uttar Pradesh

Details of Declaration (Form XXXVIII) received from the Department of Commercial Taxes and used during the assessment year

S. N.

1

Department of Commercial Taxes, Government of Uttar Pradesh

Details of declaration in Form C prescribed under The Central Sales Tax Act 1956 and used during assessment year

Date -

Place -

UPVAT - XXVI Annexure I

UPVAT - XXVI Annexure II

UPVAT - XXVI Annexure III

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S. N.

1

Total declaration used =

Department of Commercial Taxes, Government of Uttar Pradesh

Details of Form EI prescribed under the Central Sales Tax Act, 1956 used during assessment year

S. N.

1

Total certificate used - ==

Department of Commercial Taxes, Government of Uttar Pradesh

Details of Form E-II prescribed under the Central Sales Tax Act, 1956 and used during assessment year

S. N.

1

UPVAT - XXVI Annexure IV

UPVAT XXVI Annexure V

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Total declaration used - ==

Department of Commercial Taxes, Government of Uttar Pradesh

Details of Certificate in Form H prescribed under the Central Sales Tax Act, 1956 and used during assessment year

S. N.

1

Total certificates used - ==

Department of Commercial Taxes, Government of Uttar Pradesh

Details of declaration Form "F" used during assessment year

UPVAT - XXVI Annexure VI

UPVAT - XXVI Annexure VII

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S. N.

1

Department of Commercial Taxes, Government of Uttar Pradesh

Tally of the goods in trading

S. N.

1

Department of Commercial Taxes, Government of Uttar Pradesh

Quantitative tally of the goods in manufacturing/processing/packing

S. N.

1

UPVAT - XXVI Annexure VIII

UPVAT - XXVI Annexure VIIIA

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Department of Commercial Taxes, Government of Uttar Pradesh

UPVAT - XXVI

Inventories of the closing stock (in same form and condition)

Annexure IX

S.N.

11-2-3-etc

Department of Commercial Taxes, Government of Uttar Pradesh

UPVAT - XXVI

Inventories of the closing stock (finished / semi finished / waste / by product etc.) for manufacturer

Annexure X

S.N.1

1-2-3-etc

Department of Commercial Taxes, Government of Uttar PradeshUPVAT - XXVI

List of Certificate in Form 'D', received from purchasing dealer, for claiming reduction or exemption from the rate of tax

Annexure XI

S.N.

1

Department of Commercial Taxes, Government of Uttar Pradesh

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List of sales return

S. N.

1

Department of Commercial Taxes, Government of Uttar Pradesh

Computation of ITC in case of taxable goods other than non vat goods andcapital goods, purchased within UP and sold in same form and condition

S.N.

1

Note: - If space provided is not sufficient the information is to be submitted in the above format separately

Department of Commercial Taxes, Government of Uttar Pradesh

UPVAT - XXVI

Computation of ITC in case of taxable goods other than non vat goods and capital goods,purchased within UP and used in manufacturing/processing/packing of vat goods

Annexure XIV

S.N.

UPVAT - XXVI Annexure XII

UPVAT - XXVI Annexure XIII

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S.N.

1

Department of Commercial Taxes, Government of Uttar PradeshUPVAT - XXVI

Computation of RITC where taxable goods other than non vat goods and capital goods are disposed ofotherwise than by way of sale

Annexure XV

S.N.

1

Department of Commercial Taxes, Government of Uttar Pradesh

Computation of RITC where manufactured/processed/packed taxable goods other than non vatgoods and capital goods are disposed of otherwise than by way of sale

S.N.

UPVAT - XXVI Annexure XVI

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S.N.

1

1-2-3-

Department of Commercial Taxes, Government of Uttar Pradesh

ITC on capital goods (only in case of manufacturer)

S.N.

1

Department of Commercial Taxes, Government of Uttar Pradesh

RITC on capital goods (only in case of manufacturer)

S.N.

1

UPVAT - XXVI Annexure XVII

UPVAT - XXVI Annexure XVIII

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Department of Commercial Taxes, Government of Uttar Pradesh

Computation of ITC earned during the assessment year

S. N.

11-2-3-4-

5-6-7-8-9-10-11-12-13-14-15-

UPVAT - XXVI Annexure XIX

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FORM - XXVIDepartment of Commercial Taxes, Government of Uttar Pradesh

[See Rule-45(7) of the UPVAT Rules, 2008 and Section 24 (7) & 26 of the UPVAT Act, 2008]Acknowledgement and self assessment of Annual Tax under Section 26 of the UPVAT Act, 2008

Name / Address of the dealer

Taxpayer's Identification Number [TIN]Entitlement Certificate No.Gross turnover of salesNet turnover of salesGross turnover of purchaseNet turnover of purchaseTax payable on net salesTax payable on net purchaseTaxable turnover of sale in case of transfer of right to use of goodsTax payable in case of transfer of right to use of goodsTotal tax payable (9+ 10+12)ITC brought from last yearITC earned during the yearTotal ITC (14+15)ITC adjusted against UPVATITC adjusted against CSTITC adjusted against UPTTTotal (17+18+19)Net tax payableTax paid by deposit in TreasuryBy adjustment from refundTDS (Certificate XXXI)Total deposit (22+23+24)Refund/DemandTDS as contractee

Name of the dealer-

Receipt No. and date

Name and designation of official of the DCT

FORM - XXVIDepartment of Commercial Taxes, Government of Uttar Pradesh

[See Rule-45(7) of the UPVAT Rules, 2008 and Section 24 (7) & 26 of the UPVAT Act, 2008]Annual Tax Return

1- Assessment Year 2 0 - 2 0

2- Assessment Period beginning from D D M M Y Y Ending on D D M M Y Y

Date - Name and Signature of partners/proprietor/karta etc.

Place - Status -

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The Assessing Authority

Corporate circle/Sector…………………… District …………………………

I ------------------------------------------------- s/o,d/o,w/o ------------------------------- (status) --------------------------------- of

M/s ………………………………………………………………………… ........................................................ hereby,

submit the Annual Tax Return and furnish the particulars of business as follows :

2 0 2 0

d d m m y y

d d m m y

Name / Address of the dealer

4. Taxpayer's Identification Number [TIN]

Details of Bank AccountsName & address of the branch

Details of declaration or certificate received from Department of Commercial Taxes-

Name of FormXXIXXXIXXXVIIICFHEIEIIDIJAny other Form

- Annex the detail information in annexures (I - VII) whichever applicable

Inventories of Opening & Closing Stock, Purchase & Otherwise Receipts, Manufacturing and Sales of Goods inAnnexure (VIII to X)

9(a). Details of purchase (other than works contract and transfer of right to use of any goods)

5. Entitlement certificate no./date / d d m m y y

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Particular of purchase

From registered dealer in UPFrom person other than registered dealer in UPIn the course of importIn the course of exportIn the course of movement of goods from one state to another by transfer of documents of titleIn the course of inter-state trade or commerceIn Ex-UP principal's A/CIn UP principal's A/C

Capital goodsAny other purchase for any purpose

Note: Reason to be given if the details of the purchases given here defer from those given in monthly and quarterly return

9(b). Computation of Tax on the turn over of purchase made from person other than registered dealer

Name of commodity

10(a). Details of sales (other than works contract and transfer of right to use of any goods)

Particular of sales

Gross saleGross central saleGross sales within the State(i-ii)To registered dealer in UP against form DTo registered dealer without form DTo person other than registered dealer in UP

Note: Reason to be given if the details of the sales given here defer from those given in monthly and quarterly return

Computation of Tax on the turn over of sales (other than works contract and transfer of right to use of any goods)Name of commodity

11- Total tax payableParticulars

On the turn over of purchaseOn the turnover of saleTax on transfer of right to use any goodsAmount of tax deducted at source

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Tax under CST Act 1956Tax payable in case of works contract as per form XXVI BTax deposited by selling / purchasing commission agent for which Form V & VI has been obtained.Any other taxTotal tax payable

Details of ITC

Particular

ITC brought forward from the previous assessment year

ITC earned during the assessment year

Total (i+ii)

ITC adjusted against tax payable under CST Act for the current year

ITC adjusted against tax payable under UPVAT Act for the current year

ITC adjusted against dues in UPTT Act

ITC adjusted against any other dues

ITC refunded under section 41 if any

ITC refunded under section15(other than that of section 41)

Total (iv+v+vi+vii+viii+ix)ITC in balance (iii- x)

ITC carried forward for the next year

Detail of search, inspection and seizure in this Year, preceding Year and succeeding Year (If any) which are related to this year.

Date of search / inspection / seizure

Details of penalty/provisional assessment etc. and result in appeal/writDate of order

14(a)- Details of deposit along with return of tax period in Treasury/Bank

13- Information regarding search & seizure:-

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Month2

AprilMayJuneJulyAugSeptOctoNovDecJanFebMarTotal

Details of adjustments in Form XXXIII-A

Month in which adjusted

14(c) - Details of TDS in Form XXXIName and address of the Contractee

15 - Computation of Net tax payableParticulars

Total amount of tax payableAdjustment of ITC against tax payableNet tax payable(1-2)Tax deposited in bankTax deposited by way adjustmentTax deposited by way TDSTotal( 4+5+6)Balance tax payable(3-7)

DECLARATION

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I……………………………….S/o,D/o,W/o/………………………………………Status……………………….[i.e. proprietor, director, partner etc. as provided in rule-32(6)], do hereby declare and verify that, all the statements andfigures given in this return are true and complete to the best of my knowledge and belief and nothing has been willfullyomitted, suppressed or wrongly stated.

Name of the dealer-Note:- 1-This Return must be signed by a person who is authorized under rule 32 (6) of Uttar Pradesh Value Added Tax Rules, 20082-if space provided in any table is insufficient the information may be submitted in prescribed format on separate sheet.

Department of Commercial Taxes, Government of Uttar Pradesh

Detail of Transport Memo in Form XXI received from the Department of Commercial Taxes and used in the assessment year

Form No.

Total

Department of Commercial Taxes, Government of Uttar Pradesh

Details of Declaration (Form XXXVIII) received from the Department of Commercial Taxes and used during the assessment year

Number of declaration (Form XXXVIII)

2

Department of Commercial Taxes, Government of Uttar Pradesh

Details of declaration in Form C prescribed under The Central Sales Tax Act 1956 and used during assessment year

Date - Name and Signature of partners/proprietor/karta etc.

Place - Status -

UPVAT - XXVI Annexure I

UPVAT - XXVI Annexure II

UPVAT - XXVI Annexure III

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Declaration No.

2

Total declaration used =

Department of Commercial Taxes, Government of Uttar Pradesh

Details of Form EI prescribed under the Central Sales Tax Act, 1956 used during assessment year

Form No.

2

Total certificate used - ==

Department of Commercial Taxes, Government of Uttar Pradesh

Details of Form E-II prescribed under the Central Sales Tax Act, 1956 and used during assessment year

Form No.

2

UPVAT - XXVI Annexure IV

UPVAT XXVI Annexure V

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Total declaration used - ==

Department of Commercial Taxes, Government of Uttar Pradesh

Details of Certificate in Form H prescribed under the Central Sales Tax Act, 1956 and used during assessment year

Certificat e No.

2

Total certificates used - ==

Department of Commercial Taxes, Government of Uttar Pradesh

Details of declaration Form "F" used during assessment year

UPVAT - XXVI Annexure VI

UPVAT - XXVI Annexure VII

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Declaration No.

2

Department of Commercial Taxes, Government of Uttar Pradesh

Tally of the goods in trading

Opening Stock

Name of the Commodity According to rate of tax

2

Total

Department of Commercial Taxes, Government of Uttar Pradesh

Quantitative tally of the goods in manufacturing/processing/packing

Opening StockName of the Commodity According to rate of tax

2

UPVAT - XXVI Annexure VIII

UPVAT - XXVI Annexure VIIIA

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Total

Department of Commercial Taxes, Government of Uttar Pradesh

UPVAT - XXVI

Inventories of the closing stock (in same form and condition)

Annexure IX

Name of the Commodity According to rate of tax

2

Total

Department of Commercial Taxes, Government of Uttar Pradesh

UPVAT - XXVI

Inventories of the closing stock (finished / semi finished / waste / by product etc.) for manufacturer

Annexure X

Name of the commodity2

Total

Department of Commercial Taxes, Government of Uttar PradeshUPVAT - XXVI

List of Certificate in Form 'D', received from purchasing dealer, for claiming reduction or exemption from the rate of tax

Annexure XI

Name and address of the purchasing dealer

2

Department of Commercial Taxes, Government of Uttar Pradesh

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List of sales return

Name and address of the dealer to whom goods have been sold

2

Department of Commercial Taxes, Government of Uttar Pradesh

Computation of ITC in case of taxable goods other than non vat goods andcapital goods, purchased within UP and sold in same form and condition

Name of the Commodity according to rate of tax

2

Total

Note: - If space provided is not sufficient the information is to be submitted in the above format separately

Department of Commercial Taxes, Government of Uttar Pradesh

UPVAT - XXVI

Computation of ITC in case of taxable goods other than non vat goods and capital goods,purchased within UP and used in manufacturing/processing/packing of vat goods

Annexure XIV

Name of goods used in manufacturing/packing/ processing of goods in col.2

UPVAT - XXVI Annexure XII

UPVAT - XXVI Annexure XIII

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2

Total

Department of Commercial Taxes, Government of Uttar PradeshUPVAT - XXVI

Computation of RITC where taxable goods other than non vat goods and capital goods are disposed ofotherwise than by way of sale

Annexure XV

Goods disposed of otherwise than by way of sale

Name2(a)

Department of Commercial Taxes, Government of Uttar Pradesh

Computation of RITC where manufactured/processed/packed taxable goods other than non vatgoods and capital goods are disposed of otherwise than by way of sale

Name of the manufactured/pro cessed/packed vat goods

UPVAT - XXVI Annexure XVI

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2

Total

Department of Commercial Taxes, Government of Uttar Pradesh

ITC on capital goods (only in case of manufacturer)

Description of goods

2

Total

Department of Commercial Taxes, Government of Uttar Pradesh

RITC on capital goods (only in case of manufacturer)

Description of goods

2

Total

UPVAT - XXVI Annexure XVII

UPVAT - XXVI Annexure XVIII

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Department of Commercial Taxes, Government of Uttar Pradesh

Computation of ITC earned during the assessment year

Particular2

Amount of ITC as per Annexure XIIIAmount of ITC as per Annexure XIVInstallments of ITC on the stock held in the opening stock on the date of commencement of the Act

Installments of ITC on the closing stock on the date on which period of composition under section 6 terminatesInstallment of ITC in case of capital goods if anyAny other ITCTotal ITC (1+2+3+4+5+6+7)Amount of RITC as per Annexure XVIAmount of RITC as per Annexure XVIIAmount of RITC on the closing stock on the date of discontinuance of businessRITC on capital goodsAny other RITCTotal RITC (9+10+11+12+13)ITC earned(8-14)

UPVAT - XXVI Annexure XIX

Installments of ITC on the stock held in the opening stock on the date when the dealer becomes liable to tax after the commencement of the Act

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FORM - XXVIDepartment of Commercial Taxes, Government of Uttar Pradesh

[See Rule-45(7) of the UPVAT Rules, 2008 and Section 24 (7) & 26 of the UPVAT Act, 2008]Acknowledgement and self assessment of Annual Tax under Section 26 of the UPVAT Act, 2008

-

FORM - XXVIDepartment of Commercial Taxes, Government of Uttar Pradesh

[See Rule-45(7) of the UPVAT Rules, 2008 and Section 24 (7) & 26 of the UPVAT Act, 2008]Annual Tax Return

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-

Details of Bank AccountsNature of A Account No.

Opening Received Used Surrendered ClosingBalance No. No. Total No. BalanceNo. 5(a) 5(b) 6 Total No.

Amount Covered

lost/destroye

d

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Purchase Rate of tax Amount of tax

Type of t Turnover of sal Rate of tax mount of tax

Amount

Purchase turnover of vat goods

Purchase turnover of non vat goods

Purchase turnover Exempt goods

Total turn over

Turnover of Vat goods

Turn over of non vat goods

Turn over of exempt goods

Total turn over

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Amount

Name of Authority, who has conducted search & seizure

Result

Result in Appeals/writ, if pending write appeal/writ no.

TribunalSettlement Commissi

Section in which order is passed

Amount of penalty /tax

Ist AppealHigh Court/ Supreme Court

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Amount TC no. Date Name of the Name and address of the Branch3 4 5 6 7

Amount

Amount

Year from which adjusted

Order no. and date in Form XXXIII-A

Contract no. and date

Amount of TDS

Printed No. of Form XXXI

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TIN of consignee Bill/ Challan Date Amount

TIN Commodity

3 4 5 6 7 8 9

Name & address of Consignee

Description of goods

Quantity/Measure/ Weight

Name & address of the selling dealer or consignor

Tax/Sale invoice/

Date

Quantity/ Measure/ Weight as per Form XXXVIII

Amount as per Form XXXVIII

Amount as per tax/sale invoice

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Commodity

3 4 5 6 7 8 9

Total Amount

Quantity/ measure

3 4 5 6 7 8 9

Total Amount

3 4 5 6 7 8

Name & address of the selling dealer

TIN of the selling dealer

Tax/Sale invoice no. and date

Quantity/ Measure/ Weight

Amount of tax/sale invoice

Assessment Year of purchase

Name & address (with state) of the purchasing

dealer

TIN of the purchasing dealer

Place and State in which

movement of goods

commenced

Place and State to

which the goods have

been consigned

Tax/Sale invoice no.

and date

Description of goods

Name & address (with state)

affecting a sale by transfer of

the document of title to the goods

Name & address (with state) of the purchasing dealer

TIN of the purchasing dealer

Name of the place and state in which movement commenced

Name of the place

and state to which the

goods have been

consigned

Tax/Sale invoice no.

and date

Description of goods

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Total Amount

3 4 5 6 7 8 9

Total Amount

Name & address of the selling dealer

order no. and date of foreign buyer

TIN of the selling dealer

Descriptio n of goods

Tax/Sale invoice no.

and date

Quantity/ Measure/ Weight

Amount of tax/sale invoice in Rs.

/foreign currency

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3 4 5 6 7 8 9

Department of Commercial Taxes, Government of Uttar Pradesh

ReceivedTotal Disposal otherwise

Value By Purchase Value Value Value Value Value

3 4 5 6 7 8 9

Department of Commercial Taxes, Government of Uttar Pradesh

Value Received

3 4 By Purchase Total

Value Value Quantity/ Measure

5 6 7 8 9

Name & address of consignor dealer

TIN of consignor and its effective date

Transfer invoice/ date

Descriptio n of goods

Quantity/ Measure/ Weight

Amount/ estimated amount

Name of airline/railway/good s vehicle or other means of transport through which goods have been received

By Stock Transfer or Otherwise

Sale/consumption

in manufacturin

g/ processing/pa

cking

Quantity/ Measure

By Stock Transfer or Otherwise

Quantity/ Measure

Quantity/ Measure

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Department of Commercial Taxes, Government of Uttar Pradesh

3

Department of Commercial Taxes, Government of Uttar Pradesh

Quantity/ Measure of the Commodity in StockAmount3 4

Department of Commercial Taxes, Government of Uttar Pradesh

Amount of tax

3 4 5 6 7 8 9

Value of the commodity in

column 2

TIN and date of validity

Sale invoice no. and date

Description of goods

Measure/ Quantity

Sale amount in

Rs.

Rate of tax charged

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TIN of the deale

3 4 5 6 7 8 9

Total input tax credit

Value of go Value of goods Tax paid to Treasury

3(a) 3(b) 4(a) 4(b) [3(b)+4(b)]3

Department of Commercial Taxes, Government of Uttar Pradesh

Description of the goods

Tax / Sale invoice and

Date

Quantity/ Measure of

goods return

Amount of goods

return

Amount of tax in

respect of goods return

Date of receipt of goods returned

Purchased from registered dealer against tax invoice

Purchased from person other than registered

Tax paid or payable

Purchased from registered dealer against tax invoice

Purchased from

person other than

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3(a) 3(b) 3(c) 3(d) 3(e) 3(f) 3(c)+3(f))4

Department of Commercial Taxes, Government of Uttar Pradesh

2(b) 3 4 5 6

Measure / Quantity

Value of goods

Tax paid or payable to registered

dealer

Measure / Quantity

Value of goods

Tax paid to

Treasury

Total input tax credit

Purchase value exclusive of tax

Rate of tax payable under the Act

Amount of admissible

ITC

Amount of ITC claimed

Amount of reverse input tax credit (5-4)

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Name

Purchase Amount of tax paid toRegistered dealer Treasury ITC on capital goods

3a 3b 4a 4b 5a 5b 5b

Purchase of capital goods Amount of tax paid to

Registered dealer Treasury Input tax

3a 3b 4a 4b 5a 5b 5c

Goods used in manufacturing/ processing/ packing of goods mentioned

in col.2

Quantity/Measure

Purchase value

exclusive of tax

Rate of tax payable under the

Admissible ITC

Amount of ITC claimed

Amount of reverse input tax credit (6-5)

Quantity/ Measure

Value excluding tax

Amount of input tax on capital

goods

Amount of installment

Disposal of capital goods otherwise than in capital goods

Quantity/ Measure

Value excluding tax

Quantity/ Measure

Value excluding tax

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Amount3

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Result

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10

Reason for the difference if any (Attach proof )

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10 11

Value of goods

10 11 12 13

Quantity/ measure Value of goods

9 10 11 12 13

S. no. of declaration Form XXXVIII issued

Reason of difference if any

GR/RR or other documents of other means of transport

Form C received from

purchasing dealer

Name of the State issuing

Form C

GR/RR or other document of

other means of transport

Declaration in Form C

received from the purchasing

dealer

Name of the State of issuing

Form C

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10 11

Name of the airline /ship /railway /goods

vehicle or other means of transport through which the export has taken

place

No. and date of air consignment note/bill of lading/railway receipt or goods vehicle record or

postal receipt or any other document in proof of

export of goods across the customs frontier of

India

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Closing stock

Value

10

Sale/consumption in Disposal otherwise Closing stock

Value Quantity/ Measure Value Value Value

10 11 12 13 14 15 16

No. and date of air consignment note/ railway receipt or goods vehicle record or postal receipt or any other document in proof of receipt of goods

manufacturing/ processing/packing

Quantity/ Measure

Quantity/ Measure

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Total Amount

10 11

Printed No. of Form 'D'

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Amount of RITC Amount of installment

6b 5b

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