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The Central Sales Tax Form "C"

This document is a Central Sales Tax declaration form issued by the Madhya Pradesh Commercial Tax office. It contains details of a purchase made by NG Healthcare Private Limited from Accelerator Industries Pvt Ltd. The form certifies that the goods were purchased for resale and are covered by the purchasing dealer's sales tax registration. It also states that the purchasing dealer is not registered in the state where the goods will be delivered. An annexure provides invoice details of the transaction, including invoice number, date, and amount.

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Rahul Singh
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185 views

The Central Sales Tax Form "C"

This document is a Central Sales Tax declaration form issued by the Madhya Pradesh Commercial Tax office. It contains details of a purchase made by NG Healthcare Private Limited from Accelerator Industries Pvt Ltd. The form certifies that the goods were purchased for resale and are covered by the purchasing dealer's sales tax registration. It also states that the purchasing dealer is not registered in the state where the goods will be delivered. An annexure provides invoice details of the transaction, including invoice number, date, and amount.

Uploaded by

Rahul Singh
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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[This Declaration form can be printed in Triplicate as *Counterfoil * Duplicate * Original]

THE CENTRAL SALES TAX


(Registration & Turnover) Rules 1957
FORM "C"
FORM OF DECLARATION [See rule 12(1)]
(Seal Of issuing Authority)
Gwalior Circle-2

Form Serial No. M13840630


Name of Issuing State Madhya Pradesh
Office of Issue Gwalior Circle-2
Date of Issue 30/05/2019
Name and Address of the purchasing dealer in NG HEALTHCARE PRIVATE LIMITED - 41, BASANT NAGAR, MORAR,
full to whom issued along with the Registration GWALIOR, GWALIOR, Madhya Pradesh-23169120986
Certificate no
Date from which registration is valid 20/08/2014
To
TIN 03612171014
Name ACCELERATOR INDUSTRIES PVT LTD

Address of Seller
State of Seller Punjab
Certified that the goods ordered for in our
purchase order No
Supplied as per Bill/Cash memo/Challan No and
Date
Purchased from you as per Bill/cash
memo/Challan No and Date

Supplied under your challan no and Date

For the Purpose of (For invoice wise details please see Annexure)
and are covered by my/our registration certificate
No/dated issued under the Central Sales tax Act,
1956.

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.

NG HEALTHCARE PRIVATE LIMITED - 41, BASANT NAGAR, MORAR,


Name and Address of the purchasing dealer in GWALIOR, GWALIOR, Madhya Pradesh
full

The above statements are true to the best of my knowledge and belief.
Date Signature
Name of the person signing the declaration
Status of the person signing the declaration in
relation to the dealer
Note: Counterfoil to be retained by the purchasing dealer, Duplicate to be retained by the selling
The authenticity of this form can be verified at the website https://mptax.mp.gov.in
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(THIS FORM SHOULD BE IN TRIPLICATE AS *COUNTERFOIL,*DUPLICATE,* ORIGINAL)

Annexure (Invoice Details) (Form-C)

Issued By,
TIN 23169120986
Name NG HEALTHCARE PRIVATE LIMITED

41, BASANT NAGAR, MORAR, GWALIOR, GWALIOR, Madhya Pradesh


Address

Office of Issue Commercial Tax, Madhya Pradesh


Form Serial No and Date M13840630 , 30/05/2019
Issued To,
TIN 03612171014
Name ACCELERATOR INDUSTRIES PVT LTD

Address
Sr
Invoice No Invoice Date Amount
No.
1 R15 19/04/2016 24908
Total Amount Rs. 24,908.00

The above statements are true to the best of my knowledge and belief
Signature
Name of the person signing the declaration:
Status of the person signing the :
declaration in relation to the dealer

The authenticity of this form can be verified at the website https://mptax.mp.gov.in


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