FORM E-I

COUNTERFOIL

THE CENTRAL SALES TAX
(Registration & Turnover)
RULES, 1957

NAME OF STATE......
........................................
Serial No ...............................

55FORM E-I

Certificate under sub-section
**(2) of Section 6.

56[See rule 12(4)]

[To be issued (in duplicate) (i)
by the selling dealer who first
moved the goods in the case of
sale falling under section 3(a)
or (ii) by the dealer who makes
the first inter-State during
the movement of the goods 
from one State to another in 
the case of a sale falling under
Section 3(b).]

A. Name of the selling dealer
..........................................
B.(i) Name of the purchasing
dealer .................................

(ii) Address ( with state)
........................................

C. (i) Name of the place and
State in which movement com-
menced ..............................

(ii) Name of place and State no
which the goods have been 
consigned by the Signatory
............................................

D. (i) Invoice No. and date
..............................................
(ii) Description, quantity and
value of goods ........................
(iii) No. and date of  the 
declaration form 'C' received
from purchasing dealer with 
name of the State of issue
.......................................
(iv) No. and date of Railway
Receipt / Trip sheet of lorry / or
any other document of other
means of transport
...............................................

I / We the selling dealer men-
tioned above do certify that I /
We am / are registered under
the Act and am / are holding 
registration certificate

No.......................... dated
............................. in the 
State of ...............................

57[I / We further certify that (i) I /
we will pay / have paid tax 
payable under the Act or (ii) no 
tax was payable under the Act in
view of the general exemption
referred to in sub-section (2A)
58[or in pursuance to any
exemption or concession
granted under sub-section (5)]
of Section 8, on the sale of the
goods covered by documents
whose particulars are given 
above, to the appropriate sales
tax authority of the State of
.........................................
59The above statements are
true to the best of my 
knowledge and belief.

                           (Signature)

(Name of the person signing
the certificate)

(Status of the person signing 
the certificate in relation to the
dealer)]

Dated .....................................
Address (with name of the
State) ....................................
60[Explanation - In this form, item
D (iii) shall not be applicable 
in cases covered by the second
proviso to sub-section 2 of
Section 6.]

N.B--  To be retained by the
dealer issuing the certificate.

COUNTERFOIL

THE CENTRAL SALES TAX
(Registration & Turnover)
RULES, 1957

NAME OF STATE......
........................................
Serial No ...............................

55FORM E-I

Certificate under sub-section
**(2) of Section 6.

56[See rule 12(4)]

[To be issued (in duplicate) (i)
by the selling dealer who first
moved the goods in the case of
sale falling under section 3(a)
or (ii) by the dealer who makes
the first inter-State during
the movement of the goods 
from one State to another in 
the case of a sale falling under
Section 3(b).]

A. Name of the selling dealer
..........................................
B.(i) Name of the purchasing
dealer .................................

(ii) Address ( with state)
........................................

C. (i) Name of the place and
State in which movement com-
menced ..............................

(ii) Name of place and State no
which the goods have been 
consigned by the Signatory
............................................

D. (i) Invoice No. and date
..............................................
(ii) Description, quantity and
value of goods ........................
(iii) No. and date of  the 
declaration form 'C' received
from purchasing dealer with 
name of the State of issue
.......................................
(iv) No. and date of Railway
Receipt / Trip sheet of lorry / or
any other document of other
means of transport
...............................................

I / We the selling dealer men-
tioned above do certify that I /
We am / are registered under
the Act and am / are holding 
registration certificate

No.......................... dated
............................. in the 
State of ...............................

57[I / We further certify that (i) I /
we will pay / have paid tax 
payable under the Act or (ii) no 
tax was payable under the Act in
view of the general exemption
referred to in sub-section (2A)
58[or in pursuance to any
exemption or concession
granted under sub-section (5)]
of Section 8, on the sale of the
goods covered by documents
whose particulars are given 
above, to the appropriate sales
tax authority of the State of
.........................................
59The above statements are
true to the best of my 
knowledge and belief.

                           (Signature)

(Name of the person signing
the certificate)

(Status of the person signing 
the certificate in relation to the
dealer)]

Dated .....................................
Address (with name of the
State) ....................................
60[Explanation - In this form, item
D (iii) shall not be applicable 
in cases covered by the second
proviso to sub-section 2 of
Section 6.]

N.B--  To be retained by the
dealer issuing the certificate.

 

COUNTERFOIL

THE CENTRAL SALES TAX
(Registration & Turnover)
RULES, 1957

NAME OF STATE......
........................................
Serial No ...............................

55FORM E-I

Certificate under sub-section
**(2) of Section 6.

56[See rule 12(4)]

[To be issued (in duplicate) (i)
by the selling dealer who first
moved the goods in the case of
sale falling under section 3(a)
or (ii) by the dealer who makes
the first inter-State during
the movement of the goods 
from one State to another in 
the case of a sale falling under
Section 3(b).]

A. Name of the selling dealer
..........................................
B.(i) Name of the purchasing
dealer .................................

(ii) Address ( with state)
........................................

C. (i) Name of the place and
State in which movement com-
menced ..............................

(ii) Name of place and State no
which the goods have been 
consigned by the Signatory
............................................

D. (i) Invoice No. and date
..............................................
(ii) Description, quantity and
value of goods ........................
(iii) No. and date of  the
declaration form 'C' received
from purchasing dealer with
name of the State of issue
.......................................
(iv) No. and date of Railway
Receipt / Trip sheet of lorry / or
any other document of other
means of transport
...............................................

I / We the selling dealer men-
tioned above do certify that I /
We am / are registered under
the Act and am / are holding
registration certificate

No.......................... dated
............................. in the
State of ...............................

57[I / We further certify that (i) I /
we will pay / have paid tax
payable under the Act or (ii) no
tax was payable under the Act in
view of the general exemption
referred to in sub-section (2A)
58[or in pursuance to any
exemption or concession
granted under sub-section (5)]
of Section 8, on the sale of the
goods covered by documents
whose particulars are given
above, to the appropriate sales
tax authority of the State of
.........................................
59The above statements are
true to the best of my
knowledge and belief.

                           (Signature)

(Name of the person signing
the certificate)

(Status of the person signing
the certificate in relation to the
dealer)]

Dated .....................................
Address (with name of the
State) ....................................
60[Explanation - In this form, item
D (iii) shall not be applicable
in cases covered by the second
proviso to sub-section 2 of
Section 6.]

N.B-- To be furnished to the
prescribed authority in accor-
dance with the rules framed
under section 13(3) by the
appropriate State Government

 

    55.    Inserted vide GSR.896, dated 23.9.1958 (w.e.f.1.10.1958) Part-II Section 3(i) of Gazette of India Extra-
             ordinary, dated 1.10.1958.
    56.    Subs. by GSR 56(E) dt.9.2.73 w.e.f.1.4.1973.
    57.    Subs. by GSR 1321, dated 27.11.1959.
    58.    Substituted vide GSR 56-E, dated 9.2.1973 (w.e.f.1.4.1973) published in Part-II Section 3(1) of the
             Gazette of India Extraordinary, dated 9.2.1973.
    59.    Inserted vide GSR No.597-F, dated 30.12.1975. published in Part-II, Section 3(1) of the Gazette of India
             Extraordinary, dated 30.12.1975.
    60.    Ins. by GSR 395 (E) dated 14.4.87 w.e.f.14.4.87.