VAT Register III

Register of Forms D-III/D-XI received under the Bihar Value Added Tax Act, 2005
(To be furnished separately with regard to Form D-III and D-XI)

1. Name and style of the business:
2. Taxpayer Identification Number of the purchasing dealer:
3. Period to which the statement relates:
4. Name of the Circle to which the statement relates:
5. Total Number and Value of Forms received during the quarter:*
6. Total Value of Purchases of Goods specified in Schedule IV:
7. Total Sale affected during the quarter:
8. Total Tax deposited during the quarter:
Remarks

Verification
I do hereby declare that the above particulars are correct and complete to the best of my knowledge and belief.

Place:		Signature
Date:		Full Name
		Status
* Funish, as an Annexure, dealer-wise utilization statement indicating therein details of sales effected during the period.

		VAT Register III