Chhattisgarh Commercial Tax Act - 1994 Forms "FORM 30"

FORM 30

[See Rule 26(6)(a)]

DECLARATION

I, ……………………………… a dealer holding registration certificate No. …………………………. under the Chhattisgarh Commercial Tax Act, 1994 in …………………. circle, hereby declare that during the quarter commencing from ……………….. and ending on ……………….. I have dispatched taxable goods manufacture out of tax paid raw material or by using tax paid incidental goods of the value of Rs. …………………………. (rupees in words) ……………………… to the dealer …………………………… holding registration certificate No. …………………. in circle ……………………. under the said act for sale in his adat as per particulars given in the statement below:---

S. No.	Date on which goods were dispatched to the adatiya	Description of goods	Quantity	Approximate Value	Remarks
[1]	[2]	[3]	[4]	[5]	[6]

I further declare that the tax payable on the sale price obtained by the adatiya shall be paid by me

Place : ……………..

Date : ……………..

Signature of the Dealer