FORM I
Return of Charges Collected
(In respect of any Luxury provided in a Hotel/Corporate Hospital)
(See Rule 3)

 

To

The Commercial Tax Officer,

_____________________________________

_____________________________________

_____________________________________

 

I______________________________________________________________ Son/Daughter/ Wife of __________________________________________________________________ on behalf of the proprietor of the Hotel/Corporate Hospital known as________________________________________ ____________________________________ furnish herewith the statement of total and net collection of the charges in respect of the luxury provided during the month of ________________________________(month/year) and give the following connected particulars;

 

1. Name and address of the Proprietor          :
 of the Hotel/Corporate Hospital

 

2. Status or relationship of the person who      :                
     sign this return(Manager, Partner, Proprietor)

 
3. Name and address of the Hotel/          :
   Corporate Hospital

4. Names of other hotels/Corporate Hospitals      :
     and the address of every such hotel/
   Corporate Hospital (if they are under the
   same proprietorship)

STATEMENT

Rate of Charge	No. of beds/ rooms occupied	Persons occupied	Total amount of charges collected for accommodation/ for residence	Amount of charges on which deduction is claimed	Net amount of charges collected	Tax due	Tax paid particulars
							Amount	Cheque No. Crossed DD No.	Date Date
(1)	(2)	(3)	(4)	(5)	(6)	(7)	(8)	(9)	(10)

NOTE : 1. Show the collection of charges for any luxury for each rate of charges of Rs.60/- and above in respect of Hotels and Rs.500/- and above in respect of Hotels and Rs.500/- and above in respect of Corporate Hospitals and then strike the total in the last line.

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.

Signature______________________________Name(In block letters)____________________________________Status & relationship with Proprietor___________________________________