FORM-XII
Declaration notifying persons authorized to sign and to make statements
(See rule 54)

To
    The Assistant Commercial Tax Officer/The Deputy Commercial Tax Officer/The Commercial Tax Officer,

_______________________________________________________________________________   (place)
I/We                                                                                                                                                 (full address)
carrying on business known as
authorize the following person(s):-
________________________________________________________________________________________
S.No.                            Name of the Person                         Status and relationship                    Specimen signature
                                                                                             of the person to the                         of the person named    
                                                                                              dealer                                             in column(2)
__________________________________________________________________________________________
   1                                              2                                                       3                                                    4
___________________________________________________________________________________________
1.
2.
3.
to sign the returns under the Andhra Pradesh General Sales Tax Act, 1957 and the following persons:-
____________________________________________________________________________________________
S.No.                            Name of the Person                         Status and relationship                    Specimen signature
                                                                                             of the person to the                         of the person named    
                                                                                              dealer                                             in column(2)
__________________________________________________________________________________________
   1                                              2                                                       3                                                    4
___________________________________________________________________________________________
1.
2.
3.
to make statements in any enquiry under the Andhra Pradesh General Sales Tax Act, 1957, on my/our behalf.  All the
returns signed and statements made by the above authorized persons(s) shall be binding on me/us.

Place: ..................................................
                                                                                                                      Signature and relationship of the person