FORM VII-B

BOND OF INDEMNITY

(See Rule-27)

I, Shri…………………………………………………………….... son of Shri………………………………………………… residing at…………………….. P.S……………………………………….. P.O………………………………..……. District……………………………………… Proprietor/ Partner/ Manager/ Principal Officer of the business known as…………………………………………………at ………………………………. and possessing a certificate of registration bearing No…………… in the State of Odisha issued under the Odisha Sales Tax Act, 1947, do hereby declare that the declaration form bearing No………………. issued to me by the Sales Tax Officer…………………Circle, on ………………is lost/destroyed/stolen (1) from my custody before being filled in or signed by me, (2) from my custody after being filled in and signed by me but before despatch to the selling dealer, namely …………………. (3) in transit after being duly filled in and signed by me and despatched to the selling dealer, namely……………………………………

And, I, the aforesaid Shri…………………………… do hereby undertake to hold harmless and to indemnify the Government against any loss arising out of the aforesaid loss of declaration form.

And I bind myself, my heirs, executors, administrators and assignees and each one of the other persons having any share, title or interest in the aforesaid business and his heirs, executors, administrators and assignees jointly & severally for holding harmless and indemnify the Government for any such loss as aforesaid.

Proprietor/Partner/Manager/Principal Officer


FORM XI

(To be printed in quadruplicate)

2(See rules 7, 37, 37-A and 37-AA)

Challan No….. 040 – Sales Tax (b) Receipts under the State Sales Tax Act (A)- Tax Collection (B)-Surcharge (Additional Sales Tax).

3 [Tax and surcharge] Treasury

Penalty Sub-Treasury

Challan of Composition money Paid at the Branch of the State Bank of India

Fees / Interest

For the month / quarter / year ending …………………….

By whom tendered (Details to be furnished Name, Address etc.)

Name & Address & Registration number of the dealer on whose behalf money is paid

Payment on account of

Amount

   

Tax deducted U/s-13-AA

Tax under Section 12

3 [Surcharge under section 5-A]

Penalty under section 9-B (3) 11(3)/ 12(5) / 12 (8) / 13(5)-AA (5)/[13 –AAA(5)]

Composition money……………

Interest payable under section 12(4-a)……………………….

Fees under the Act and the Rules………………………

Interest payable under section 13 (6)…………………………..

Payment of security under Sub-section (3)-(a) of Section 9 4[Tax deducted under section 13-AAA]…………………….

Rs. P.

   

Total………………………….

 

Rupees (in words)………………………………………… Paise…………………….

Date………                                                      Signature of the Dealer or Depositor

 

(For use in the Treasury)

  1. Received payment of Rs……………………………..(in words)…………………
  2. Date of entry……………………………

Treasurer / Accountant Treasury Officer /

Agent or Manager


FORM XI-C

PART – I

Application for grant of certificate of no deduction / deduction of tax at source from Works Contractor under Sub-section (5) (a) of Section 13-AA of the Odisha Sales Tax Act, 1947 (To be submitted in duplicate).

  1. Name, address and to be filled by the applicant.
  2. Status and relationship of person making the application with respect to the business.
  3. Location of business / Works Contract Executed.
  4. The nature of Works Contract executed and date of commencement (copy of contract to be filed with application)
  5. Cost of the total value of the project / work.
  6. Person involved for completion of Project / work as per the agreement.
  7. Nature of agreement, i.e., whether composite or divisible contract.
  8. Material component and value thereof as per the agreement.
  9. Extent of labour and service component.
  10. Whether interest in fiduciary in any company, firm or association of persons carrying on business in Odisha or in course of inter-State Trade.
  11. Whether any sales tax proceedings are pending or have been taken in the past. If so, details of the same.
  12. Details of yearwise payment, if already received, if any, in respect of the work.
  13. Name and address of the Contractor / deducting authority under whom the work is executed.

                                                                                               Signature of applicant.

Place ……………

Date……………..


FORM XII

Application for refund of tax under section 14 of the Odisha Sales Tax Act, 1947

(See Rule – 39)

To

The Commissioner of Sales Tax.

I……………………. Proprietor/ partner/ manager/ principal officer (authorised departmental) of the business known as ………….. bearing Registration Certificate number …………….. whose only / chief place of business in the district of …………… is situated at ……………. P.O…………………….. pray for refund of Rs. ……………… being the amount of excess [tax/ surcharge/ penalty/ security/ interest] paid by me. The refund may be paid in cash / by Refund Adjustment Order payable at the ……………….. Treasury / Sub-treasury.

  1. Period of assessment in respect of which refund is claimed.
  2. order of assessment

  3. Date on which ________________________________ was passed
  4. Final order on appeal, revision (………) or reference.

  5. [(i) Amount of tax / surcharge / penalty paid……………..]
  6. (ii) Challan Number ………………………………………..

    (iii) Date of payment………………………………………

  7. Amount as finally determined…………………………….
  8. (Quote No. and date of order)……………………………..

  9. Amount of refund claimed.
  10. Grounds for claiming refund.

I ……………………. the applicant named above, do hereby declare that what is stated herein is true to the best of my knowledge and belief, (and also further declare that the amount of refund claimed above has been paid by me that the amount or any part thereof has not been realised by me by way of tax or otherwise from any person or persons.

                                                                                        Signature

 


FORM XII - A

Statement of Claim for Refund of Tax paid on sales or purchases of Declared Goods

(See Rule – 42-A)

To

……………….. Circle

The Assistant Sales Tax Officer,

Sales Tax Officer,

I……………………. Proprietor/ partner/ manager/ principal officer (authorised departmental) of the business known as ………….. bearing Registration Certificate number …………….. whose only / chief place of business in the district of …………… is situated at ……………. P.O…………………….. pray for refund under the provisions of rule 42-A of the Odisha Sales Tax Rules, 1947 in respect of goods, the particulars of which are given below. The amount may be made payable at the Treasury / Sub-treasury at…………………………….

  1. Serial Number.
  2. Date of payment of tax in respect of the goods under section 5 of the Act, number and date of Treasury Challan by which tax was paid into the Treasury or number and date of money order or bank draft thereof.
  3. Description of the goods.
  4. Quarter in which the sale or purchase was included in the turnover.
  5. Amount of tax paid under section 5 of the Act.
  6. By whom sold in the course of inter-State trade or commence.
  7. Quarter in which the sale was included in the turnover of the dealer against column 6 and tax paid.
  8. The name and address of the dealers, if any who bought and sold the goods to the dealer specified in column (6)

I ……………. the applicant named above do hereby declare that what is stated above is true to the best of my knowledge and belief and also further declare that the amount of refund claimed above has been paid to Government and was not claimed earlier.

                                                                                                    Signature

 


FORM XXVI

(See Rule 91)

SALES TAX TRIBUNAL, Odisha

Statement showing the particulars of appeals/applications for reference disposed of by the

Tribunal during the period from ………………..

 

 

Serial No.

Number of appeals/application for reference on the file of the Tribunal

Name and address of the applicant/appellant (including registration No. if any)

Name and address of the respondent/opponent (including registration No. if, any)

Result of disposal (including extgent of relief given, if any,)

 

Remarks

1

2

3

4

5

6

 

 

         

 


FORM XXXII-C

Forwarding Note

(See Rule 94-D)

Name of Transport Co.

Booking Agency

To

The Manager/In-charge

Please receive the under mentioned consignments and forward by Road Transport to as consigned below :

 

By whom consigned Number of Articles

Value

Description and Private Marks

Sender’s weight

       

Name Address

Name Address

Quintals, Kilograms

1

2

3

4

5

6

7

8

 

 

 

             

 

I do hereby certify that I have satisfied myself that the description marks and weight or quantity of goods consigned by me have been correctly entered in this forwarding note.

Signature of the Dealer ………………………………………

Or his authorised agent ………………………………………

(To be filled in by the Transporter) Date ……………. Address …………………………

Actual weight

Weight charges

No. of Articles

No. of Transport Receipts

Date

1

2

3

4

5

 

 

 

       

 


FORM XXXII-D

(Despatch Register to be maintained by the Transporter)

(See Rule 94-D)

Date

From

To

No.of package alongwith the method of packing

Nature of Goods

Value of Goods

Name and complete address of the consignor with Registration Certificate No. if any, under the State/Central Sales Tax Act.

Name and complete address of the consignee with Registration No. under the State Sales Tax Act/Central Sales Tax Act.

1

2

3

4

5

6

7

8

               

 

 

Transport Receipt No.

Challan No.

Vehicle No.

Freight charged

Date of movement of goods

Remarks

9

10

11

12

13

14

           

 

 


FORM XXXII-E

(Delivery Register to be maintained by the Transporter)

(See Rule 94-D)

Sl.No.

Date of Delivery

Place from which goods are despatched

Name of Transport Company

Name and complete address of the consignor with Registration Certificate No. under the State Sales Tax Act, if registered

Name and complete address of the consignee with Re. No. under the State/Central Sales Tax Act.

1

2

3

4

5

6

           

 

 

 

No. of packages alongwith the method of packing

Nature of goods

Value of goods

Freight charged

(i)

Octroi

(ii)

Commission

(iii)

Total

(i+ii+iii)

Name, signature and address of the consignees, authorised persons taking delivery of goods

7

8

9

 

10

 

11

12

               

 

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