form C

COUNTERFOIL			DUPLICATE			ORIGINAL
THE CENTRAL SALES TAX			THE CENTRAL SALES TAX			THE CENTRAL SALES TAX
(Registration & Turnover) RULES, 1957			(Registration & Turnover) RULES, 1957			(Registration & Turnover) RULES, 1957

FORM ‘C’¹			FORM ‘C’¹			FORM ‘C’¹
Form of Declaration			Form of Declaration			Form of Declaration
[See Rule 12(l)]			[See Rule 12(l)]			[See Rule 12(l)]

Name of issuing State ……………………………. ............…………			Name of issuing State ……………………. ............………			Name of issuing State ……………………. ............………
Office of issue ……………………………………...............……….			Office of issue ……………………………….............…….			Office of issue ……………………………….............…….
Date of issue ……………………………………..................……….			Date of issue ……………………………………................			Date of issue ……………………………………................
Name of the purchasing dealer to whom issued along with his Registration Certificate			Name of the purchasing dealer to whom issued along with his Registration Certificate			Name of the purchasing dealer to whom issued along with his Registration Certificate
No.………………………………………...............................			No.………………………………………...............................			No.………………………………………...............................
Date from which registration is valid…….......................			Date from which registration is valid…….......................			Date from which registration is valid…….......................
		Seal of Issuing Authority	Serial No…………		Seal of Issuing Authority	Serial No…………		Seal of Issuing Authority
To			To			To
.............................................................. *(Seller) ....................................................................			.............................................................. *(Seller) ....................................................................			.............................................................. *(Seller) ....................................................................
Certified that the goods			Certified that the goods			Certified that the goods
¹Ordered for in our purchase Order No................................ dated ................................................ and supplied as per Bill /Cash memo ²/challan No. .................................... dated ............................. as stated below * purchased from you as per Bill/Cash Memo /Challan No. ......................................... dated ............... as stated below * supplied under your Challan No. ............................... dated .............................. are for resale packing of goods for sale/ resale and are covered by my /our registration certificate No................................. dated .................................... issued under the Central Sales Tax Act, 1956.			¹Ordered for in our purchase Order No................................ dated ................................................ and supplied as per Bill /Cash memo ²/challan No. .................................... dated ............................. as stated below * purchased from you as per Bill/Cash Memo /Challan No. ......................................... dated ............... as stated below * supplied under your Challan No. ............................... dated .............................. are for resale packing of goods for sale/ resale and are covered by my /our registration certificate No................................. dated .................................... issued under the Central Sales Tax Act, 1956.			¹Ordered for in our purchase Order No................................ dated ................................................ and supplied as per Bill /Cash memo ²/challan No. .................................... dated ............................. as stated below * purchased from you as per Bill/Cash Memo /Challan No. ......................................... dated ............... as stated below * supplied under your Challan No. ............................... dated .............................. are for resale packing of goods for sale/ resale and are covered by my /our registration certificate No................................. dated .................................... issued under the Central Sales Tax Act, 1956.
(a)	** It is further certified that I/we am/are not registered under section 7 of the said act in the State of..................... in which the goods covered by this Form are/will be delivered.		(a)	** It is further certified that I/we am/are not registered under section 7 of the said act in the State of..................... in which the goods covered by this Form are/will be delivered.		(a)	** It is further certified that I/we am/are not registered under section 7 of the said act in the State of..................... in which the goods covered by this Form are/will be delivered.
Name and address of the purchasing dealer in full...........................................................................……… Date. ......................................................................………			Name and address of the purchasing dealer in full...........................................................................……… Date. ......................................................................………			Name and address of the purchasing dealer in full........................................................................... Date. ......................................................................………
³The above statements are true to the best of my knowledge and belief.			³The above statements are true to the best of my knowledge and belief			³The above statements are true to the best of my knowledge and belief
(Signature)			(Signature)			(Signature)
(Name of the Person signing the declaration.)			(Name of the Person signing the declaration.)			(Name of the Person signing the declaration.)

(Status of the person signing the declaration in relation to the dealer)			(Status of the person signing the declaration in relation to the dealer)			(Status of the person signing the declaration in relation to the dealer)
**** Particulars of Bill /Cash Memo /Challan			**** Particulars of Bill /Cash Memo /Challan			**** Particulars of Bill /Cash Memo /Challan

Date. ................................ No. ..............................			Date. ................................ No. ..............................			Date. ................................ No. ..............................
Amount ..................................................			Amount ..................................................			Amount ..................................................
* Name and address of the seller with name of the State.			* Name and address of the seller with name of the State.			* Name and address of the seller with name of the State.
*** Strike out whichever is not applicable.			*** Strike out whichever is not applicable.			*** Strike out whichever is not applicable.

(Note: - To be retained by the purchasing dealer.)			(Note: -To be retained by the purchasing dealer.)			(Note: - To be furnished to the prescribed authority in accordance with the rules framed under section 13(4)(e) by the appropriate State Government.
Use in manufacturing /processing of goods for sale use in mining.			Use in manufacturing /processing of goods for sale use in mining.			Use in manufacturing /processing of goods for sale use in mining.
1. Inserted vide SRO 896 dated 23-9-58 (w.e.f. 1-10-58) part-II Section 3 of Gazette of India Extraordinary dated 1-10-58.			1. Inserted vide SRO 896 dated 23-9-58 (w.e.f. 1-10-58) part-II Section 3 of Gazette of India Extraordinary dated 1-10-58.			1. Inserted vide SRO 896 dated 23-9-58 (w.e.f. 1-10-58) part-II Section 3 of Gazette of India Extraordinary dated 1-10-58.
2. Inserted vide GSR 962 (E) dated 30-12-76 Part-II Section 3(i) of the Gazette of India Extraordinary dated 30-12-76.			2. Inserted vide GSR 962 (E) dated 30-12-76 Part-II Section 3(i) of the Gazette of India Extraordinary dated 30-12-76.			2. Inserted vide GSR 962 (E) dated 30-12-76 Part-II Section 3(i) of the Gazette of India Extraordinary dated 30-12-76.
3. Substituted vide GSR 55(E) dated 9-2-73 (w.e.f. 1-4-1973) Part-II, Sec. 3, Gazette of India Extraordinary dated 9-2-73.			3. Substituted vide GSR 55(E) dated 9-2-73 (w.e.f. 1-4-1973) Part-II, Sec. 3, Gazette of India Extraordinary dated 9-2-73.			3. Substituted vide GSR 55(E) dated 9-2-73 (w.e.f. 1-4-1973) Part-II, Sec. 3, Gazette of India Extraordinary dated 9-2-73.
* GSR 26(E) dated 1-2-74 Part-II, Sec. 3; GOI Extraordinary dated 1-2-74			* GSR 26(E) dated 1-2-74 Part-II, Sec. 3; GOI Extraordinary dated 1-2-74			* GSR 26(E) dated 1-2-74 Part-II, Sec. 3; GOI Extraordinary dated 1-2-74

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