Chhattisgarh Commercial Tax Act - 1994 Forms "FORM 04"

Form 4

[See rule 8(1)]

Application for grant of registration certificate u/s 22 or 23 of

The Chhattisgarh Commercial Tax Act, 1994

To,

The Commercial Tax Officer,

……………….. Circle.

1. I ………………………………. Proprietor /*Manager /Partner /Director of the business known as …………………………………………………….. /Officer in charge of the business of selling or supplying goods carried on by the Central Government /*State Government of Chhattisgarh in The COMMERCIAL TAX Department hereby apply for grant of a registration certificate under section 22/ *section 23 of the Chhattisgarh Commercial Tax Act,1994.

2. The particulars with regard to the business and the person(s) having interest in the business aforesaid, are as under, -

[i]

Name and full address of the business

[ii]

Status of business (whether a proprietorship, partnership, a public or private limited company, HUF, Society, Cooperative society, Club or Association

[iii]

Nature of business

(a) Importer /manufacturer /works contractor/ co-operative society /other dealer and if a manufactured and by products that would be obtained in the course of manufacture.

(b) Wholly /partly agriculture, horticulture mining, manufacturing, wholesale or retail distribution /contracting /catering /producing or repairing or any combination of one or more of them and if wholesale or retail distribution, particulars of goods in which such business shall be carried on

[iv] Name of the proprietor / Names of the partners / Directors with full present and permanent address & extent of the interest in the business
Name	Address	Age	Father’s Name	Home Address	Extent of Interest in Business	Signature	Signature and Address of attesting the signature in column [7]
[1]	[2]	[3]	[4]	[5]	[6]	[7]	[8]

Note - Attach passport size photograph of the proprietor or each of the adult partners of the firm or each adult coparcener of HUH as the case may be, on a separate paper duly attested by a lawyer or a Tax practitioner or a Gazetted Officer.

[v]

Particulars about the proprietor ,partner or any other person having interest in the business if he has interest in any other business anywhere in India

(a) Full name of the person

(b) Name(s) of the firm(s) with registration certificate number under the Sales tax Act, and

(c ) Full Address

(d) Extent of Interest

[vi]

Registration certificates number(s) under the State Sales tax Act and the CST Act. (If the business is registered an any other State)

[vii]

Accounting year followed

[viii]

Language and script in which accounts are maintained

[ix]

Date of commencement of the business

[x]

Turnover from the date of commencement of business to the date of making the application

[xi]

(a) Date on which the turnover exceeds the limit specified in sub-section (5) of section 5

(b) Date of liability to pay tax

[xii]

(a) If the turnover has not exceeded the limit specified in sub-section (5|) of section 5, whether it is likely to exceed within a period of 12 months from the date of commencement of the business.

(b) If the turnover is likely to exceed as aforesaid ,reasons therefore

[xiii]

Whether applied for registration certificate under the CST Act. If so the date of first inter State sale if the application has been made under section 7(1) of that Act

[xiv]

(a) Number and date of Mandi License, (if any, enclose copy)

(b) Number and date of license under the Chhattisgarh Shops and Establishment Act, (if any, enclose copy)

(c ) Number and date of license under the Essential Commodities Act, (if any, enclose copy)

[xv]

Particulars of immovable property owned by the persons having interest in the business.

S. No.	Name of the person	Description and other particulars of the immovable property	Extent of ownership in the immovable property
[1]	[2]	[3]	[4]

[xvi]

Particulars of permanent account numbers if the person or persons are income tax assessee

S. No.	Name of the Person	Permanent Account No.	Name and number of the income tax ward
[1]	[2]	[3]	[4]

[xvii]

(a) Capital investment on the date of commencement of the business

(b) If the business is an industrial unit

[i] date of commencement of commercial production

[ii] capital investment in fixed assets on the case of commercial production

1. Land
2. Building
3. Plant and Machinery

[i] Contribution of the person or persons having interest in the business

[ii] Borrowing from the financial institutions (give names)

[xviii]

Particulars of the bankers through whom the business is transacted

S. No.	Name of the Bank	Full Address of The Bank	Bank Account Number
[1]	[2]	[3]	[4]

[xix]

(a) Names and address of the additional places of business in the State, if any

(b) Particulars of godowns / ware houses if any

[xx]

(a) Raw materials required for use in the manufacture (enclose a detailed list)

(b) Incidental goods required for use in manufacture(enclose detail list)

[xxi]

Particulars about the business premises (whether owned by any persons or persons have interest in the business or taken on rent or on lease or allotted by the Government), (if taken on rent enclose copy of a receipt of rent)

[xxii]

Date of first purchase of raw materials

[xxiii]

Description of goods manufactured as also by products/waste products obtained in the course of manufacture.

Names and address of two dealers registered under the Chhattisgarh Commercial tax Act,1994 identifying the business(enclose letters of identification)

CGCT No.

ii.

CGCT No.

Particulars about the payment of registration fee (give Chalan number and date)

EXEMPTED VIDE NOTIFICATION

No. F-10/6/2004/CT/V(19) dt .23-02-2004

(Old Noti. No. F-10/23/2003/CT/V(26)

dt. 03-04-2003)

Place
Date
		Signature

I, hereby declare that the statements made and particulars given are true to the best of my knowledge and belief.

Place
Date
		Signature

* Strike out whichever is not applicable.