FORMS X-FORM OF WAY BILL
(See rule 45(4))
                                                                                                           Number

1.  Office of issue 
 
 

                                                    Date        Month        Year
2.   Date of issue of
      way bill by
      consignor
     


3.   Name and address of the Dealer / Person                                                                    Registration Number
      consigning, the goods.


      Name
      Address    
       
       APGST
 
        CST

         State

 

 

4.  Full Address of place (a) From which consigned.                                (b)  to which consigned.

            Name of  Place                                                                            Name of  Place

            Address                                                                                        Address

 

5.  If the consigner is transporting goods.

                    (a)  In pursuance of sale for purpose of delivery to the buyer; or (b) After purchasing them; or
                    (c)  From one of the shops or godown to an agent for sale; (d) From shop or godown to another
                          shop of godown for purpose of storage or sale; or (e) To his principal, having purchased them
                          on his behalf; or (f) To his agent for sale on consignment basis.
                

                          (Whichever is applicable and write corresponding alphabet in the box)
 

THE NAME AND ADDRESS OF THE DEALER / PERSON TO WHOM THE GOODS ARE CONSIGNED OR FROM WHOM GOODS WERE PURCHASED.

         (Buyer or self or Agent or principal)                                                                    Registration Number


      Name
      Address    
       
       APGST
 
        CST

         State

 

 

6.   Description, quantity and value of goods.

Sl.No.                               Commodity                                    Invoice No.               Quantity                    Value of
 No.                 Code                                   Name                       Date                                                       Goods
  1.
  2.
  3.
  4.

Name and address of the owner of the goods vehicle or boat by which the Goods are consigned.
                                                                                                                                     Vehicle / Boat Number


      Name
      Address    
       


       

                                                                                                                             

                I / We certify that to best of my / our knowledge the particulars furnished here are true  and correct.

                                                                                                                                    Signature of the Consignor.

Form X was  Subs. by G.O.Ms.No.688, Rev. dt.11.10.1988