8/13/2019 63475934-Gujrat-Form-403

1/1

To,

The Officer Incharge

Check Post

1. Place to which goods are dispatched RAJKOT District GUJARAT

2. Place from which goods are dispatched ROORKEE District HARIDWAR

3. Details of goods invoice No. Date

Name : GUJARAT

Address : Certificate No.:

Telephone :0281-2370110

Fax :

5. Nature of Transaction :

(3) Depot Transfer (5) For Job works/works Contract(4) Consignment to Branch/ Agent (6) Any Other

Name :

Address :452, Adarsh Nagar

ROORKEE - 247 667

Telephon 01332-272852

Fax :

Unit Rate ofQuantity Tax Rs. P.

1

1 No.

(C/B) 4.5% 12536 0.00

7. Transporter Details : 9. Drivers Details

(a) Name

(b) Address

(c) Driver Licence No.

8. Vehicle No. L.R.No. Date (d) Licence Issuing State

10. Name & Address of Person in Charge of goods Driver's Signature

Place: Seal Signature

Date: Designation:

For Commercial Tax Department/Check Post

Entry No.

Vehicle Date Time

Arrival

Depart

Date Signature Designation

Code

Date :

Value

24091100540 dt. 01-07-2002

Plot No. 138/141, Vavdi Survey No. 43/1,

Gondal Road,

RAJKOT 360 004

Ph.: 0281-2370110

Description of Goods

Date :

TIN. Reg No. 05009119092

State : Uttarakhand

TIN. Reg No.

Certificate No.:

Consigned Value Rs. Twelve Thousand Five Hundred Thirty Six Only

(1) Inter State Sale

(2) Transfer of Documents of Tit

6. Consigners' Details

SES Instruments Pvt. Ltd.

Date :

Date :

Commondity

(c) Owner/Partner Name :

S.No.

(b) Address :

Scientific Instruments

(a) Name :

FORM 403 (See Gujrat Rule (5) of 51)

Declaration Under Section 68 of the Gujarat Value Added Tax Act 2003

(for goods coming into the state from outside the state)

State :

1/7/2011

4. Consignee' Details

SIPL/710

M/s JEI Bearings

Reason of Abnormal Stoppage Result if any