Form No 402

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FORM 402 ORIGINAL / DUPLICATE / TRIPLICATE

(See rule 51)


Declaration under section 68 of the Gujarat Value Added Tax act,2003 Serial
(For movement of goods within the State or goods moving outside the State) No.

To,
The Officer in Charge
Check Post
(1) Place from which goods are dispatched____________________________ District_____________________
(2) Place to which goods are dispatched____________________________ District_____________________
(3) Details of goods invoice No.____________________________
Date________________________
(4) Consignor's details :
Name & State
Address Reg. Certificate No. Date

Telephone CST Reg. No. Date


Fax No.
(5) Nature of Transaction
1. Inter state sale 2. Transfer of documents of title 3. Depot Transfer

4. Consignment to Branch/Agent 5. For job Works/Works contract 6. For export 7. Any Other

(6) Consignee's Details :


Name & State
Address Reg. Certificate No. Date

Telephone CST Reg. No. Date


Fax No.

Consigned Value Rs.____________________________


Sr. Description of Goods Commodity Code Unit Quantity Rate of Value
No. Tax

(7) Transporter's Details :__________________________________________________________________________________


(a) Name____________________________________________________________________________________________
(b) Address ________________________________________________________________________________________
(c) Owner/Partner's Name____________________________________________________________________________
(8) Vehicle No. :___________________________________
(9) Driver's Details
(a) Name____________________________________________________________________________________________
(b) Address ________________________________________________________________________________________
(c) Driving Licence No.________________________________________________________________________________
(d) Licence issuing State______________________________________________________________________________
(e) Driver's Signature_________________________________________________________________________________
(10) Name of the Address of person in charge of goods._________________________________________________________

seal :

Place : ________________________ Signature : ________________________

Date : Designation :

For Commercial Tax Department / Check Post


Entry No. Reason of abnormal stoppage Result if any
Vehicle Date Time
Arrival
Depart

Date : ________________________

Signature
Designation

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