FORM  A6
Statement of Monthly Return
(See Rule 17F of A.P.G.S.T. Rules, 1957)

 

To

The Deputy Commercial Tax officer

______________________________

______________________________

I __________________________________________________________________________ Son of ________________________________________________________________________ working as ___________________________________ in the _________________________________________ Department of Government furnish herewith Statements of total and taxable turnover in respect of the sales effected by the Department for the month of ________________________________________.

 

1.  Name of the Officer of the Department            :           

 

2.  Designation of the Officer                                    :           

 

3.  Name of the Department                                    :           

 

4.  Address of the Office                                                :           



                      

5.  Particulars of payment

         (a) Total Tax payable                         :           

        (b)  Tax Paid                                           :

                (i)       Cheque/DD particulars

                            Number                               :                                               Date            :

                            Bank                                     :                                              Branch        :

 

        (ii)      Cash(Receipt number if paid)

             

              Receipt No.          :                                                             Date            :

 

       
        (iii)    Challan Particulars

               

                Number               :                                                               Date            :

 

                Name of Treasury            :

 

    (c)     Balance payable, if any (a)-(b)            :



Statement of Commodity-wise tax and Turnover details No. of Commodities for Which Particulars are given

Commodity

 

Total Turnover

Exempted

Turnover

Net Turnover

Total

Tax due

Amount

of tax

 collected

Tax

provisionally

paid

Balance

due

Particulars

of payment

of balance

due

 Description

Code

    (1)

(2)

(3)

(4)

(5)

(6)

(7)

(8)

(9)

(10)



 

 

 

 

 

 

 

 

Amount Rs.



 

 

 

 

 

 

 

 

Cheque/

D.D.No.& Date



 

 

 

 

 

 

 

 

ChallanNo.

and Date

 

 

 

 

 

 

 

 

 

Treasury



 

 

 

 

 

 

 

 

 



 

 

 

 

 

 

 

 

 



 

 

 

 

 

 

 

 

 



 

 

 

 

 

 

 

 

 



 

 

 

 

 

 

 

 

 



 

 

 

 

 

 

 

 

 



 

 

 

 

 

 

 

 

 



 

 

 

 

 

 

 

 

 



 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Grand Total

 

DECLARATION :

I, _______________________________________________________ Son/Daughter/Wife of __________________________________________________ declare that, to the best of my knowledge and belief, the information furnished in the above Statement is true and complete.

 

Place :                                                                                           Signature ________________________________   

Date :                                                                                             Status and Relationship to the dealer _____________________

                                                                                                         Name (in block letters) __________________________