FORM H

COUNTERFOIL
THE CENTRAL SALES TAX
( R & T )
RULES, 1957
71FORM 'H'
Certificate of Export
[See rule 12(10)]

Sl.No.

  Seal of the
  Issuing Authority

Name of Issuing State

Office of Issue

Date of Issue

Name and complete address
of the exporter

Registration No. 
of the exporter under the
Central Sales Tax Act,
1956, if any.

To
................................................
................................................

(Name and complete address
of the seller)

Sales tax registration number
of the seller:

(a)  under the relevant State
sale tax law

(b)  under the Central Sales
tax Act, 1956.

Certificate I : Certified that the
goods ( the particulars whereof
have been specified in items (1)
and (2) of the Schedule below)

supplied in pursuance of our
purchase order No .............
dated ...............................
purchased from you as per
bill / cash memo / challan No
................ dated ..................
for Rs. .................... have
been sold by me / us, in the 
course of export out of the 
territory of India, as per 
details given in items(3) to 
(6) of the said Schedule, and
that the said goods were 
purchased from you by  me /
us after, and for the purpose of
complying with, the agreement
or order No. ......................
dated ................................
for or in relation to such export.

Certificate II :  It is further 
certified that non-liability to
tax under the Central Sales
Tax Act, 1956 in respect of 
goods referred to in Certificate 
I has not been claimed from
any other person and that no
other certificate for such
non-liability has been issued to 
any other person in India in
respect of those goods.

Certificate III :  It is further
certified that in case the goods
covered by this certificate are
reimported into India by me / us
after their export, I / We under
take to inform the sales tax
authority of the person to whom
this certificate has been supplied,
about the fact of such reimport
within a period of one month
from the date of reimport of
the said goods into India.

The Schedule

A.  Particulars of goods
(1)  Description of goods
(2)  Quantity of goods

B.  Details regarding export

(3)  Name of airport, seaport or
land customs station through
which the goods have been
exported.

(4)  Name of the airlines / ship /
railway / goods vehicle or other
means of transport through
which the export has taken place.

(5)  Number and date of air
consignment note / bill of
lading / railway receipt or goods
vehicle record or postal receipt
or any other document in proof
of export of goods across the
customs frontier of India
(Certified copy of such air
consignment note / bill of
lading / railway receipt / goods
vehicle record / postal receipt/
other document to be enclosed)

(6)  Description, quantity /
weight and value of the goods
exported under the document
referred to in item(5) above.

Verification

The above statements are true
to the best of my knowledge
and belief and nothing has
been concealed therefrom.

Signature with date ....................

Name of the person signing
the certificate

Status of the person signing
the certificate in relation to
the exporter.

Note:-  To be retained by 
the exporter.

COUNTERFOIL
THE CENTRAL SALES TAX
( R & T )
RULES, 1957
71FORM 'H'
Certificate of Export
[See rule 12(10)]

Sl.No.

  Seal of the
  Issuing Authority

Name of Issuing State

Office of Issue

Date of Issue

Name and complete address
of the exporter

Registration No. 
of the exporter under the
Central Sales Tax Act,
1956, if any.

To
................................................
................................................

(Name and complete address
of the seller)

Sales tax registration number
of the seller:

(a)  under the relevant State
sale tax law

(b)  under the Central Sales
tax Act, 1956.

Certificate I : Certified that the
goods ( the particulars whereof
have been specified in items (1)
and (2) of the Schedule below)

supplied in pursuance of our
purchase order No .............
dated ...............................
purchased from you as per
bill / cash memo / challan No
................ dated ..................
for Rs. .................... have
been sold by me / us, in the 
course of export out of the 
territory of India, as per 
details given in items(3) to 
(6) of the said Schedule, and
that the said goods were 
purchased from you by  me /
us after, and for the purpose of
complying with, the agreement
or order No. ......................
dated ................................
for or in relation to such export.

Certificate II :  It is further 
certified that non-liability to
tax under the Central Sales
Tax Act, 1956 in respect of 
goods referred to in Certificate 
I has not been claimed from
any other person and that no
other certificate for such
non-liability has been issued to 
any other person in India in
respect of those goods.

Certificate III :  It is further
certified that in case the goods
covered by this certificate are
reimported into India by me / us
after their export, I / We under
take to inform the sales tax
authority of the person to whom
this certificate has been supplied,
about the fact of such reimport
within a period of one month
from the date of reimport of
the said goods into India.

The Schedule

A.  Particulars of goods
(1)  Description of goods
(2)  Quantity of goods

B.  Details regarding export

(3)  Name of airport, seaport or
land customs station through
which the goods have been
exported.

(4)  Name of the airlines / ship /
railway / goods vehicle or other
means of transport through
which the export has taken place.

(5)  Number and date of air
consignment note / bill of
lading / railway receipt or goods
vehicle record or postal receipt
or any other document in proof
of export of goods across the
customs frontier of India
(Certified copy of such air
consignment note / bill of
lading / railway receipt / goods
vehicle record / postal receipt/
other document to be enclosed)

(6)  Description, quantity /
weight and value of the goods
exported under the document
referred to in item(5) above.

Verification

The above statements are true
to the best of my knowledge
and belief and nothing has
been concealed therefrom.

Signature with date ....................

Name of the person signing
the certificate

Status of the person signing
the certificate in relation to
the exporter.

Note:-  To be retained by 
the dealer selling goods to
the exporter.

 

COUNTERFOIL
THE CENTRAL SALES TAX
( R & T )
RULES, 1957
71FORM 'H'
Certificate of Export
[See rule 12(10)]

Sl.No.

  Seal of the
  Issuing Authority

Name of Issuing State

Office of Issue

Date of Issue

Name and complete address
of the exporter

Registration No. 
of the exporter under the
Central Sales Tax Act,
1956, if any.

To
................................................
................................................

(Name and complete address
of the seller)

Sales tax registration number
of the seller:

(a)  under the relevant State
sale tax law

(b)  under the Central Sales
tax Act, 1956.

Certificate I : Certified that the
goods ( the particulars whereof
have been specified in items (1)
and (2) of the Schedule below)

supplied in pursuance of our
purchase order No .............
dated ...............................
purchased from you as per
bill / cash memo / challan No
................ dated ..................
for Rs. .................... have
been sold by me / us, in the 
course of export out of the 
territory of India, as per 
details given in items(3) to 
(6) of the said Schedule, and
that the said goods were 
purchased from you by  me /
us after, and for the purpose of
complying with, the agreement
or order No. ......................
dated ................................
for or in relation to such export.

Certificate II :  It is further 
certified that non-liability to
tax under the Central Sales
Tax Act, 1956 in respect of 
goods referred to in Certificate 
I has not been claimed from
any other person and that no
other certificate for such
non-liability has been issued to 
any other person in India in
respect of those goods.

Certificate III :  It is further
certified that in case the goods
covered by this certificate are
reimported into India by me / us
after their export, I / We under
take to inform the sales tax
authority of the person to whom
this certificate has been supplied,
about the fact of such reimport
within a period of one month
from the date of reimport of
the said goods into India.

The Schedule

A.  Particulars of goods
(1)  Description of goods
(2)  Quantity of goods

B.  Details regarding export

(3)  Name of airport, seaport or
land customs station through
which the goods have been
exported.

(4)  Name of the airlines / ship /
railway / goods vehicle or other
means of transport through
which the export has taken place.

(5)  Number and date of air
consignment note / bill of
lading / railway receipt or goods
vehicle record or postal receipt
or any other document in proof
of export of goods across the
customs frontier of India
(Certified copy of such air
consignment note / bill of
lading / railway receipt / goods
vehicle record / postal receipt/
other document to be enclosed)

(6)  Description, quantity /
weight and value of the goods
exported under the document
referred to in item(5) above.

Verification

The above statements are true
to the best of my knowledge
and belief and nothing has
been concealed therefrom.

Signature with date ....................

Name of the person signing
the certificate

Status of the person signing
the certificate in relation to
the exporter.

Note:-  To be furnished to
the prescribed authority
in accordance with the
rules made by the State
Government under Section 13.

 

71.    Ins. vide GSR 762(E) dt.17.12.1977 published in Part-II Sec. 3(i) of the Gazette of India
         Extraordinary dt.17.12.77.