FORM
IIApplication for
Certificate of Enrolment/Revision of
Certificate of Enrolment under the Andhra Pradesh Tax on
Professions, Trades, Callings and
Employments Act,
1987(See Rules
4(1) and 6(2))
To
The Professional
Tax
Officer,_______________________________________________________________________________________
I hereby apply for a certificate of
enrolment / revision of certificate of enrolment under the above mentioned Act
as per particulars given below:
1.
Name of the applicant
:
2.
Full Postal Address
:
3.
Date of birth and Age
:
4.
Profession, Trade or Calling
:
5.
Period of standing in profession
in years and
months
:
6.
Numbers of other places of works
:
(Please give the address of the places)
7.
Annual turnover of all sales / purchases :
*8. Number of workers engaged in the
factory
:
*9. Number of employees in the
establishment :
*10. If
Co-operative Society whether State Level :
District Level or Mandal Level
*11. Number of Vehicles for which permit
under
M.V.
Act is held
:
2 Wheelers
:
Trucks and
:
Buses
:
Total
:
*12. Enrolment No. of previous certificate,
if any
:
*13 If registered under APGST Act
1957/ CST
Act, 1956 the No. of registration
Certificates held
:
APGST Act, 1957
:
CST Act,
1956
:
*14. Grounds on
which revision is sought
:
(attach additional sheets if necessary)
The above
statements are true to the best of my knowledge and belief.
Dated :
Signature with status.*Please fill up
whichever is applicable.
For office Use Only
Enrolment No.
:Date of
Enrolment
:
Signature of Issuing Officer
Acknowledgement(Particulars of
name and address to be filled by applicant)
Received an application for enrolment in Form
From
Name :
Address:
Application No:
Dated :
Signature of Receiving Officer,