Form VAT 36 (See rule 64 and 65) Declaration for transport of goods to and from the State of Punjab COUNTERFOIL

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APPENDIX 23 Page 1 of 10

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Form VAT 36 (See rule 64 and 65) Declaration for transport of goods to and from the State of Punjab COUNTERFOIL 1. Date of issue Serial 2. Name & Address of the dealer to whom issued 3. VRN/ TRN of the dealer to whom issued: 4. Particulars of the Issuing Officer Name District Ward Signature (Seal of the issuing authority) (The above entries to be filled in by the issuing authority) 5. Description of Punjab dealer sending goods from Punjab or receiving goods in Punjab Name: Address: VRN/TRN: 6. Description of the person to whom goods are sent or from whom goods are received by Punjab dealer Name: Address: TIN 7. Nature of transaction: (sale / consignment/ branch transfer/ job work and like)

8. Description, Quantity and value of goods Sl Description Invoice/Challan and date Code Name Quantity Value of goods (Rs.) In In figures words Total value of goods (Please use the reverse side if the names of the commodities are more) 9. Name and address of the transport company / owner of the vehicle by which the goods are consigned: Address: 9A Vehicle : 9B GR & Date:. COUNTERFOIL (Reverse side of Form VAT- 36) 8. Description, Quantity and value of goods Sl Description Invoice/Challan Quantity Value of goods and date (Rs.) Code Name In figures In words Total value of goods in figures In words

Form VAT-36 (See rule 64 and 65) Declaration for transport of goods to and from the State of Punjab ORIGINAL FOIL 1. Date of issue Serial 2. Name & Address of the dealer to whom issued 3. VRN/ TRN of the dealer to whom issued: 4. Particulars of the Issuing Officer Name District Ward Signature (Seal of the issuing authority) (The above entries to be filled in by the issuing authority) 5. Description of Punjab dealer sending goods from Punjab or receiving goods in Punjab Address: VRN/TRN: 6. Description of the person to whom goods are sent or from whom goods are received by Punjab dealer Address: TIN 7. Nature of transaction: (sale / consignment/ branch transfer/ job work and like) 8. Description, Quantity and value of goods Sl Description Code Name Invoice/Challan and date Quantity Value of goods (Rs.) In In figures words Total value of goods (Please use the reverse side if the names of the commodities are more) 9. Name and address of the transport company / owner of the vehicle by which the goods are consigned:

Address: 9A Vehicle : 9B GR & Date: DECLARATION I / We declare that I / we am / are registered dealer under the Punjab Value Added Tax Act, 2005, holding VRN / TRN and the statements made are correct to the best of my/ our knowledge and belief. Name of the dealer Signature of proprietor / partner/ authorized person with stamp

ORIGINAL FOIL (Reverse side of Form VAT- 36) 8. Description, Quantity and value of goods Sl Description Invoice/Challan and date Quantity Value of goods (Rs.) Code Name In figures In words Total value of goods in figures In words Name of the dealer: Signature of Proprietor / partner / authorized person with stamp: Code & Name of the Information Collection Centre Date of Endorsement: Date Month Year Signature of the endorsing VAT officer / Inspector (Seal)

Form VAT -36 (See rule 64 and 65) Declaration for transport of goods to and from the State of Punjab DUPLICATE FOIL 1. Date of issue Serial 2. Name & Address of the dealer to whom issued 3. VRN/ TRN of the dealer to whom issued: 4. Particulars of the Issuing Officer Name District Ward Signature (Seal of the issuing authority) (The above entries to be filled in by the issuing authority) 5. Description of Punjab dealer sending goods from Punjab or receiving goods in Punjab Address: VRN/TRN: 6. Description of the person to whom goods are sent or from whom goods are received by Punjab dealer Address: TIN 7. Nature of transaction: (sale / consignment/ branch transfer/ job work and like)

8. Description, Quantity and value of goods Sl Description Code Name Invoice/Challan and date Quantity Value of goods (Rs.) In In figures words Total value of goods (Please use the reverse side if the names of the commodities are more) 9. Name and address of the transport company / owner of the vehicle by which the goods are consigned: Address: 9A Vehicle : 9B GR & Date: DECLARATION I / We declare that I / we am / are registered dealer under the Punjab Value Added Tax Act, 2005, holding VRN / TRN and the statements made are correct to the best of my/ our knowledge and belief. Name of the dealer Signature of proprietor / partner/ authorized person with stamp

DUPLICATE FOIL (Reverse side of Form VAT- 36) 8. Description, Quantity and value of goods Sl Description Code Name Invoice/Challan and date Quantity Value of goods (Rs.) In In figures words Total value of goods in figures In words Name of the dealer: Signature of Proprietor / partner / authorized person with stamp: Code & Name of the Information Collection Centre Date of Endorsement: Date Month Year Signature of the endorsing VAT officer / Inspector (Seal)

PART A To The Designated Officer, Place., District. FORM VAT-36 A [ See rule 65 ] Application for issue of FORM VAT- 36 1. I Proprietor/Managing partner/managing Director/ General Attorney/Head of Department (or any other Joint Officer/Officers duly authorised by him in writing) of the below mentioned firm hereby apply on behalf of the firm for issue of (number) Form VAT- 36. 2. List of the (number) used Form VAT- 36 from serial number to serial no. is attached herewith. 3. List of the (number) FORM VAT- 36 in transit with serial number to serial number is also attached herewith. Signature of the applicant Name Status Place Date : Name of the firm : Address VRN Number PART B (To be retained in the office of Designated Officer) 1. Number of Forms VAT-36 in possession of the taxable person including issued under Punjab General Sales Tax Act, 1948. 2. Number of Forms issued against this application 3. Serial Number of Forms issued From : To: 4. Date of issue of Forms 5. Total Number of Forms available with the taxable person. 6. Signature of the taxable person in token of having received the Forms mentioned in row 3. 7. Counter signature of the Designated Officer PART C (To be affixed on the Register of the taxable person) 1. Number of Forms VAT-36 in possession of the taxable person 2. Number of Forms issued against this application 3. Serial Number of Forms issued From : To: 4. Date of issue of Forms 5. Total Number of VAT-36 Forms available with the taxable person. 6. Signature of the taxable person in token of having received the forms mentioned in row 3. 7. Counter signature of the Designated Officer.

FORM VAT- 36 B [ See rule 65 ] Register Showing Account of the Form VAT-36. 1. Place: District : 2. Registration Number : 3. Name & Address of the taxable person: Sr. Name and address of the dealer of the other State Registration certificate of the dealer mentioned in Col. 2 Particulars of the good imported / exported Bill and date Value of goods imported / exported Serial of VAT-36 Forms issued Date of issue 1. 2. 3. 4. 5. 6. 7. 8. 9. Remarks

FORM VAT-36C [ See rule 65 ] INDEMNITY BOND Know all men by these presents that I/We (Full address of the taxable person) registered under the Punjab Value Added Tax Act, 2005 under registration dated In the state of Punjab (hereinafter called the Obliger) am/are held and firmly bound up to Government of Punjab (hereinafter called the Government) in the sum of (rupees in words) (hereinafter referred to as the said sum ) to be paid to the Government on demand for which payment well and truly be made. I/we bind myself/ourselves and my/our heirs, executors administrators, legal representatives and assigns and the persons for the time being having control over my/our assets and affairs by these presents. Signed this day of two thousand and Whereas clause (e) of sub rule (2) of Rule 52 of the Punjab Value Added Tax Rules, 2005 requires that in the event a blank or a duly completed form VAT-36 is lost while it is in the custody of the purchasing dealer or the selling dealer or in transit as the case may be, is required to furnish an indemnity bond. In the case of the dealer registered in the State of Punjab, the indemnity bond is to be furnished to the Assessing Officer from whom the said form was obtained and in the case of a dealer of other State to the notified authority of his State. And whereas the obliger herein is a taxable person of Punjab/ other State. And whereas the obliger has lost the declaration Form VAT-36 bearing No which was blank/duly completed and was issued by Designated Officer and which was issued by me/us to (taxable person of other State) / received by me/us from (name of the taxable person of Punjab) in respect of the goods mentioned below: Sr.No Description of goods Quantity Amount. of bill / invoice / challan Date Now the condition of the above written bond is such that the obliger shall in the event of a loss suffered by the Government (in respect of which the decision of the Government or the authority appointed for the purpose, shall be final and bonding on the obliger) as a result of the misuse of the form, pay to the Government on demand and without demur the said sum of Rs Rupees (in words) and shall otherwise indemnity and Government as a result of the misuse of such form, then the above written bond shall be void and of on effect but otherwise shall remain in full force effect and virtue. The obliger further undertakes to mortgage/charge to properties specified in the schedule here under written by execution of proper deed of mortgage/charge for the Payment of the said sum. SCHEDULE (Give details of properties mortgaged/charged) And these presents also witnesseth that the liability of the obliger hereunder shall not be impaired or discharged by reason of any forbearance, act or omission of the Government or for any time being granted or indulgence shown by the Government. The Government agrees to bear the stamp duty, if any, chargeable on these presents. In witness whereof the obliger has set his hand/has caused these presents executed by his authorised representatives on the day month and year above written in the presence of: - 1. 2. (Obliger s Signature) Accepted for and on behalf of the Governor of Punjab by name and designation of the officer duly authorised in pursuance of Article 299 (1) of the Constitution of India, to accept the Bond for and on behalf of the Governor of Punjab. In the presence of: - 1. 2. (Signature of the Designated officer with name, designation and seal