(1) The fee payable for seeking clarifications under sub- section (5) of section 26 of the Act shall be one hundred rupees;
(2) The fee specified in sub-rule (1) shall be paid by way of Crossed Demand Draft in favour of the Commissioner Panaji, Goa, or deposited in the Government Treasury by challan in Form-27 hereto.
- 15 - FORM 1 [See rule 4(2)] Application for the grant of a Registration Certificate as a dealer under Goa Tax on Entry of Goods Act, 2000 To, The Registering Authority, .................................
.................................
.................................
I, ......................................................................, son of ...................................................
carrying on business whose particulars are given below, hereby apply for Registration under Rule 4 of the Goa Tax on Entry of Goods Rules, 2000.
(1) Name and full postal address of the applicant (if there is a trade name the trade name shall also be given)……………………………………………………………………
(2) Name and address of the Manager of the business, if a Manager has been so appointed …………………………………………..............................................................
(3) Name and address and status of the person who signs this application (as regards status, state whether proprietor, manager, director, partner .......................................
(4) Name and full postal address of the principal place of business (with particulars of building, name and number, ward name and number, road name, street name etc.)…………………………...……………………………………………………………… …………………………….
(5) Name and full postal address of all the other places of business elsewhere in the State with particulars of building name and number, ward name and number, road name, street name, etc., for each place of business (if the space in this column is found to be insufficient additional sheet may be used and duly signed) ...........................................................……….
(6) Complete list of godown in which the (scheduled goods) are stored and address of every such godown ................................................................................................…………
(7) Date of commencement of business ..........................................................................…
(8) The language in which the accounts are kept and maintained ....................................
(9) The accounting year followed by the applicant ……………………………………….
(10) Whether the applicant is a proprietor, firm, company, society, club, association of persons, Hindu Undivided family, or trust, etc. (here give full description) ….…………………………………………………………………………………………
(11) Name(s) and address(es) of the proprietors, partners, members, all persons having any interest in the business (additional sheets with the following columns shall be used, if necessary.) .............................................................................................................................
Sl.
N o.
Name in full of Name of father Age of each person Permanent Postal address Present postal address of each Extent of interest of each person in Signature of person Name, address and - 16 - each person of each person of each person person the business signature of witness attesting signature (1 (2) (3) (4) (5) (6) (7) (8) (9)
(12) Whether business is wholly wholesale, or mainly wholesale and partly retail, whether manufacturer etc. (here enter the general nature of business conducted by the dealer) ........................................................................................................................................
(13) The total value of purchases/stock receipts of scheduled goods in the year preceding that to which the application is submitted …………………………………………………
(14) Actual value of purchases/stock receipts of scheduled goods in the year upto the date of submission of the application ...............................................................................……
(15) Amount of registration fee paid with particulars of Receipt No. and date ....................
(16) Amount of fee paid for copies of certificate for the other places of business with particulars of receipt No. and date, challan No. and date, cheque No. and date/name of the Treasury/Bank etc. ............................................……………………………………………… DECLARATION I, ................, son of ............... hereby declare that to the best of my knowledge and belief the information contained in this application given above is true and correct.
Place:
Name, address and signature if the person signing with status and relationship to the dealer (here state manager, director, partner, etc.)
Dated:
(For official use by the Registering Authority)
(1) Date of receipt of application ....................................................................................
(2) Nature of order passed by the Registering Authority in the application .........................
(3) Licence No. and date, if any ......................................................................................…..
(4) Date of issue of Registration Certificate ...........................................................…… Signature of the registering authority with date - 17 - FORM 2 [See rule 4(4)] Certificate of Registration Registration No.
This is to certify that * *Here enter the name and style under which the business is carried on. Whose principal place of business is situated at ……….. has been granted a registration under section 4 of the Goa Tax on Entry of Goods Act, 2000, subject to the provisions of the said Act and the Rules framed thereunder and also to the following conditions:
(1) This Certificate should be exhibited at a conspicuous place within the premises of the business.
(2) A correct account should be kept of the daily transactions at the place of business.
(3) A registered dealer shall afford all facilities for the checking of his stock and shall, at all reasonable times, produce for inspection accounts or other documents and shall furnish fully and correctly any information in his possession as may be required for the purpose of these Rules by any officer empowered in this behalf.
(4) The prescribed statement(s) and returns should be sent to the prescribed authority within the prescribed time.
(5) This Registration Certificate should not be transferred or sold nor should it be amended without the permission of the registering authority which should be applied for and obtained.
(6) All corrections in this certificate should be made and attested by the registering authority.
(7) The registered dealer shall be responsible for all the acts of his manager, agent or servant. The dealer has additional places of business as noted below:
(a)
(b)
(c) This Registration Certificate is valid from ............................................ until cancelled.
Signed Dated: Registering Authority - 18 - FORM 3 [See rule 8(1)] Monthly Statement of Tax
(1) Month and year.
(2) Registration Certificate No. under the Goa Tax on Entry of Goods Act, 2000.
(3) Name and full address of the dealer.
(4) Style of business.
(5) Status.
(6) Tax payable for the month (as per Table below).
(7) Tax paid (Challan/Receipt No. and date to be furnished).
(8) Balance due/Excess paid.
DECLARATION I, .................. do solemnly declare that to the best of my knowledge and belief the information furnished in the above statement is true and complete and that it relates to the month covering the period from ............... to ........................
Place:
Signature Name of the Signatory Proprietor/Partner/Manager/ /Director Date:
Details of the value of Scheduled Goods dealt in during the month and Tax payable S l .
N o .
Descri ptions of the goods Total Value of goods purchas ed//rece ived (both from within and outside the state) Value of goods purchased //received from within the local area Value of goods purchased// received from outside the local area but returned to the suppliers Value of goods purchases//re ceived from outside the local area but sent out of the local areas otherwise than by way of sale excluding the amount shown under col. 4(b) Purchased value of motor vehicle imported from outside the state on which tax has already been paid by filing statement in Form 4 Total deduct ions 4(a)+4
(b) + 4(c)+4
(d) Tota l valu e of good s liabl e to tax (3-5) R at e of ta x T a x d u e ( R s.
P s.
) ( 1 )
(2) (3) 4(a) 4(b) 4(c) 4(d) (5) (6) (7) (8) - 19 -
(i)
(ii)
(iii)
(iv)
(v)
(vi)
(viii)
(ix)
(x)
(xi)
(xii)
(xiii)
(xiv)
(xv)
(xvi) Total - 20 - FORM 4 (See rule 27) Return for turnover and Tax payable by an importer of the Motor Vehicle under the Goa Tax on Entry of Goods Act, 2000
(1) Name and address of the importer :...........................................................................…
(2) Registration Certificate No.(if registered): ………………………………..
(3) Period of import: From ............................................. to ....................................
I. Description of motor vehicles imported into the local area from any place outside the State:
Class of motor vehicle Mode l Engine No.
Chassis No.
Purchas e value Rate of Tax Tax payabl e Tax paid Balance due excess paid
(1) (2) (3) (4) (5) (6) (7) (8) (9) II. Tax paid challan No.
........................................................................................................
DECLARATION I, ................... do solemnly declare that to the best of my knowledge and belief the information furnished in the above return is true and complete and that it relates to the period mentioned above.
Signature Name of the signatory - 21 - FORM 5 [See rule 8(2)] To, The Dealer, Take notice that according to the statement sent by you for the month…………under section 18(1) of the Goa Tax on Entry of Goods Act, 2000, you are liable to pay tax of Rs……….only for the month of …............... which is still payable by you. You are hereby called upon to pay the said amount within ten days from the date of service of this notice by remittance to the Government Treasury by challan in Form- 27 failing which the amount will be recovered as provided under, sub-section (2) of section 19 of the said Act.
Value of goods as provisionally determined by the Assessing Authority in respect of Nature of goods Rate of Tax Tax Total Total Place:
Assessing Authority Date :
- 22 - FORM 6 [See rule 8(3)] NOTICE To, ........................…… ...............................
...............................
Registration Certificate No. .......................
Take notice that you have been provisionally assessed under the Goa Tax on Entry of Goods Act, 2000 to a tax of Rs. ………… (Rupees) ...................... (in words) …….................only for the month covering the period from .......................to ......................... after deducting the tax already paid, you have to pay a further sum of Rs……………..(Rupees)..………………………… (in words) only.
This balance of tax shall be paid within 30 days from the date of service of this notice, by remittance into the Government Treasury by challan in Form-27, failing which the amount will be recovered in accordance with sub-section (4) of section 19 and you will also be liable to penalty as provided in sub-section (2) of Section 19.
(i) Total Tax provisionally assessed Rs.
(ii) Less Tax paid provisionally under sub-rule (1) and/or (2) of Rule 7 Rs.
(iii)Balance of tax due Rs.
Place:
Date:
Signature of the Assessing Authority.
- 23 - FORM 7 [See rule 8(4)] Certificate of Exemption from Submission of Returns Whereas ...................... (dealer) holding R.C. No. ................................date............... and carrying on business known as .............................. in the district of ................. situated at...........has shown to my satisfaction that goods dealt in by are not eligible to tax under the provision of the Goa Tax on Entry of Goods Act, 2000. It is hereby certified that the said……………(dealer) is not required to furnish any statement in Form-3 appended to the Tax on Entry of Goods Rules, 2000 during the year ending ....................the day of………. year.
Place:
Signature Designation Date:
RENEWAL Date of renewal Year for which renewed Signature and Designation of the Issuing/Assessing Authority
(1) (2) (3) - 24 - FORM 8 [See rule 11(3) (i)] Proposition Notice To, ………………………………….
………………………………….
Registration Certificate No. .........................................................................................
Whereas being liable to pay tax under the Goa Tax on Entry of Goods Act, 2000, you have failed to submit the return of turn-over in Form-28 within the time prescribed under Rule 11, for the period ........................... I propose to determine and assess the tax payable by you to the best of my judgment under section 14 and also to direct the payment of penalty under sub-section (5) of section 14.
You are hereby given an opportunity of being heard accordingly, you are required to attend in person or by a legal practitioner or by an agent authorised in writing at (place)………………….at………………….(time).................. on (date)………………and to show cause why you should not be assessed to tax and penalty for the said period. You may produce or cause to be produced your account books and other documents and file the return for scrutiny and consideration while making the assessment.
Place: Signature Date: Designation - 25 - FORM 9 [See rule 11 (3)(ii)] Office of the Entry Tax Officer Ward Dated Proposition Notice To, Shri ..................................................
……………………………………..
……………………………………..
Whereas I am of the opinion that the return of value of goods in Form-28 of the year ending ............................... submitted by you is incorrect and incomplete, I propose to determine your total value of the goods for the said period to the best of my judgement at Rs……................. and Rs…................................respectively. The reason for non-acceptance of the return and the basic of the pro- posed assessment are furnished below. You are hereby called upon to show cause against the proposed assessment, adducing evidence, if any, either in person or through a legal practitioner an agent authorised in writing, at ............................a.m./p.m. on......……….......... at my office at ..............................................failing which it will be presumed that you have no objections to the proposed assessment and orders as deemed fit will be passed.
Place:
Date:
Assessing Authority - 26 - FORM 10 [See rule 11(5), 24 and 25] Year of Assessment:
Registration Certificate No.
To, ..........................................
..........................................
..........................................
NOTICE Take notice that you have been finally assessed under Goa Tax on Entry of Goods Act, 2000, of Rs................................. (Rupees ....................................... (in words) only, for the year ending………….the period upto and inclusive of the date of discontinuance of business, and that, after deducting the total amount of the payment already made by you towards the tax for the year, you have to pay a further sum of Rs......... (Rupees………..(in words) only). This balance of tax shall be paid within thirty days from the date of service of this notice by remittance into the Government Treasury, by challan in Form-27 failing which the amount will be recovered as if it were an arrear of land revenue and you will be liable to penalty as provided in section 19 of the Goa Tax on Entry of Goods Act, 2000.
Total Tax payable Total Tax paid Balance due Date of assessment Signature of the Assessing Authority Place:
Date:
- 27 - FORM 11 [See rule 11(5)] Year of Assessment:
Registration Certificate No.
To, ..........................……..
....................................
....................................
NOTICE Take notice that you have finally assessed under the Goa Tax on Entry of Goods Act, 2000, a tax of Rs.................... (Rupees) ………………….. (in words) only for the year ending……….The total amount of tax paid by you already is Rs .................. (Rupees ........................ (in words) only) that is………..in excess of the tax due.
2. The sum of Rs...........paid by you in excess as stated above is refunded/adjusted towards ..............due by you for the year .............
The refund payment order and refund adjustment order is/are enclosed.
Value of goods determined by the assessing authority is given (below).
Total Tax payable Total Tax paid Excess amount due Date of Assessment Place: Signature of the Assessing Date: Authority.
- 28 - FORM 12 [See rule 16(2)] Form of Appeal against an order of assessment under section 14 To The Deputy/Assistant Commissioner of Entry Tax The day of 2000
(1) Name (s) of appellant (s)
(2) Assessment year
(3) Assessing Authority passing the assessment orders disputed
(4) Date on which the order was communicated
(5) Address to which notice may be sent to the appellant
(6) Relief claimed in appeal
(a) Value of goods determined by the assessing authority
(b) If value is disputed
(i) Disputed value
(ii) Tax due on the disputed value
(c) If rate of tax is disputed value
(i) Value involved
(ii) Amount of tax disputed
(d) Any other relief claimed
(7) Grounds of appeal, etc.
(Signed) Appellant(s) (Signed) Authorised representative, if any VERIFICATION I/We, ............................................ the appellant(s) named in the above appeal do hereby declare that what is stated therein is true to the best of my/our knowledge and belief.
Verified today the date of 2000 (Signed) Appellant(s) - 29 - (Signed) Authorised representative, if any Notes
(1) The appeal should be accompanied by the order appealed against in original or by a certified copy thereof unless the omission to produce such order or copy is explained to the satisfaction of the appellate authority and by proof of payment of the tax admitted by the appellant(s) to be due or of such instalments thereof as might have become payable.
(2) The appeal should be written in English and should set forth. Concisely and under distinct heads the grounds of appeal (without any argument or narrative) and such grounds should be numbered consecutively.
- 30 - FORM 13 [See rule 17(i)] Form of Appeal Memorandum to the Tribunal Appeal Memorandum to the Tribunal under section 29(1) of the Goa Tax on Entry of Goods Act, 2000. Before the Administrative Tribunal, at Panaji.
No. ..................... of ................ 2000 Appellant(s) V Respondent
(1) Place in which the assessment was made.
(2) Assessment year.
(3) Assessing Authority passing the assessment/order disputed.
(4) Deputy Commissioner/Assistant Commissioner passing the order in appeal under Section 28.
(5) Date of communication or the order now appealed against.
(6) Address to which notices may be sent to the appellant.
(7) Address to which notice may be sent to the respondent.
(8) Relief claimed in appeal a. Turn-over determined by the Assessing Authority passing the assessment order disputed.
b. Turn-over confirmed by the Deputy Commissioner/Assistant Commissioner.
c. If turn-over is disputed,
(i) Disputed turn-over ;
(ii) Tax due thereon.
d. If the rate of tax is disputed,
(i) Turn-over involved;
(ii) Amount of tax disputed.
e. Any other relief claimed.
(9) Grounds of appeal, etc.
(Sd/-) Appellant(s) (Sd/-) Authorised representative, if any VERIFICATION I/We, ....................................... the appellant(s) do hereby solemnly declare that what is stated above is true to the best of my/our knowledge and belief.
- 31 - (Sd/-) Appellant(s) (Sd/-) Authorised representative, if any Place:
Date:
Notes
1. The appeal should be in quadruplicate and should be accompanied by four copies (atleast one of which should be the original or authenticated) of the order appealed again against and also four copies of the order of the assessing authority.
2. The appeal (when filed by any person other than an officer empowered by the State Government under sub-section (1) of Section 20 should be accompanied by a treasury receipt in support of having paid the fee calculated at the rate of 2 per cent. of the disputed tax subject to a minimum of Rs. 20 and a maximum of Rs. 200. The fee should be credited in a Government Treasury to the following head of account.
Major Head:
Minor Heads:
Sub-Head:
3. The appeal should be written in English and should set forth concisely and under distinct heads the grounds of appeal (without any argument or narrative) and such grounds should be numbered consecutively.
- 32 - FORM 14 [See rule 17(4)] Form of Memorandum of Cross Objections Before the Tribunal under section 29 (3) of the Goa Tax on Entry of Goods Act, 2000 Cross Objection No. .................... of 2000..................... In appeal No. ........................
of 2000 ....................
Appellant(s) V Respondent
(1) Appeal No. allotted by the Tribunal to which memorandum of cross objections relates.
(2) Office in which assessment was made.
(3) Section under which the order appealed against was passed.
(4) Assessment year in connection with which the memorandum of cross objection is preferred.
(5) Date of receipt of notice of appeal filed by the appellant to the Tribunal.
(6) Address to which notice may be sent to the respondent (objector).
(7) Address to which notices may be sent to the appellant(s).
(8) Relief claimed in the memorandum of cross objections. Grounds of cross objections.
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8) etc.
(Signed) (Respondent) (Authorised representative, if any) - 33 - VERIFICATION I, ................... the respondent, do hereby declare that what is stated above is true to the best of my information and belief.
Verified today the ............... day of ............. 2000 ......
Signed Notes
(1) The memorandum of objections must be quadruplicate.
(2) The memorandum of cross objections should be written in English and should setforth concisely and under distinct heads, the cross objections should be numbered consecutively.
(3) The number and year of memorandum of cross objections will be filled in the office of the Appellate Tribunal.
(4) The number and year of appeal as allotted by the office of the Tribunal and appearing in the notice of appeal received by the respondent is to be filled in here by the respondent.
(5) If the space provided is found insufficient, separate enclosures may be used for the purpose.
- 34 - FORM 15 (See rule 19) Security bond for stay of collection of Tax or other amount in dispute Before the Tribunal/Deputy Commissioner/Assistant Commissioner No. ............................. Dated:
Security Bond executed in favour of the Governor of Goa and his successors in office and assigns. Whereas ...................holding R.C. No........... in the office of the ..has filed an appeal before the Tribunal/Deputy Commissioner/Assistant Commissioner ............ against the order of .................................................................................................in his/its order No . .................... dated ...............................................................................and the said appeal is pending.
And whereas the said appellant has applied for direction in regard to the payment of disputed tax/penalty and has been called upon to furnish security.
Accordingly, and in consideration whereof I/We............hereby personally undertake and bind my- self/ourselves, my/our heirs, successors and legal representatives to pay the Government of Goa the sum of Rs. ................ To the Government and mortgage ............................................................................................... /charge properties in the schedule hereunto annexed for the payment of the said sum of Rs to the Government of Goa and covenant that if the aforesaid appellant complies with all the directions in regard to the payment of tax or other amount made by the Tribunal/Deputy Commissioner/Assistant in the said appeal this bond shall be void and of no effect, otherwise it shall remain in full force and effect.
In witness whereof I/We .............hereunto affix my/our hands and seal this day …… dated......................
Witnesses: Appellant/Surety
(1)
(2) - 35 - FORM 16 (See rule 20) Memorandum of Appeal Order under section 33 of the Goa Tax on Entry of Goods Act, 2000 Appeal Order No.
Appellant(s) V/s Respondent Appeal against the order of the Commissioner, dated and passed in.
(1) Office in which the assessment was made:
(2) Assessment year:
(3) Assessing Authority passing the original order:
(4) State if the order was modified at any time previously by any officer subordinate to the Commis- sioner and if so in what manner (state the results of modification briefly):
(5) Date of communication of the order of the Commissioner:
(6) Address to which notice may be sent to the appellant:
(7) Address to which notice may be sent to the respondent:
(8) Relief claimed in appeal:
(a) Value determined by the Assessing Authority.
(b) Value as modified prior to suo motu by the Commissioner.
(c) Value of goods modified and fixed by the Commissioner.
(d) Relief claimed.
(e) Grounds of appeal.
(i) state the facts disputed briefly.
(ii) state the questions of law raised decision by the High Court.
(Signed) Appellant(s) (Signed) Authorised representative, if any VERIFICATION I/We, ............................................................... the appellant(s) do hereby declare that what is stated above is true to the best of my/our knowledge and belief.
Verified today the day of (Signed) Appellant(s) (Signed) Authorised representative, - 36 - if any Notes
(1) The appeal should be accompanied by a certified copy of the order of the Commissioner appealed against.
(2) The appeal should be accompanied by a sum of Rs. 500/-.
(3) The appeal should be written in English and should set forth concisely and under distinct heads, the facts of the case, grounds of appeal and the points of law raised consecutively.
- 37 - FORM 17 (See rule 35) Return of clearing, forwarding, transporting, shipping, etc.
Name and address of the clearing, forwarding, house transporting agent/shipping agent or steamer agent ...……................................ etc…………………the periods to which return relates.
Sl.
No.
Date of Clearing, forwarding, transporting, shipping Name and full address of the consignor Name and full address of the consignee Number and date of delivery/ note/ Bill of lading/R.R etc. No.
date Description of goods Quanti ty No. of packin gs Weigh t Value of goods Remarks
(1) (2) (3) (4) (5) (6) (7) (8) (9) (10) DECLARATION I/We, .................................. declare that to the best of my/our knowledge that the information furnished in the above return is true and correct and that it relates to the period of ...........................
Place: Name and signature:
Status of the person signing Date :
- 38 - FORM 18 (See Rule 36) Statement to be submitted by owners, of vehicles or boats, etc.
1. Number of the Vehicle:
2. Name and address of the person furnishing statement :
3. Status:
4. Period for which the statement relates:
DECLARATION I, ........................... declare to the best of my knowledge that the information furnished in the above statement is true and correct.
Name and signature with status of the person signing Sl.No. Name and address of persons whom the goods are delivered No. And date of delivery note/bill of lading etc.
Description of goods Quantity No. Of packings Weight V alue of goods Remarks ( 1)
(2) (3 )
(4) (5 ) ( 6)
(7) (8 ) (8 ) - 39 - FORM 19 [See rule 15(6)] Delivery note
(1) Name and complete address of the consignor.
(2) Registration Certificate No. of the consignor under the Goa Tax on Entry of Goods Act, 2000.
(3) Bill No. or Cash Memorandum issued by the seller.
(4) Name and complete address of the consignee.
(5) Registration Certificate No. of the consignee under the Goa Tax on Entry of Goods Act,
2000.
(6) Destination of goods from to
(7) Description of goods .
(8) Quantity of goods.
(9) Name and address of the person-in-charge of the goods (Name of the Transport Agency).
(10) Name and address of the person-in-charge of the vehicle.
(11) Vehicle No.
(12) Signature of the officer-in-charge of the Transport Agency/the person-in-charge of the vehicle.
Place: Signature of consignor/consignee Date:
- 40 - FORM 20 [See rule 15(7)] Notice calling for Accounts and other Documents Whereas I desire to ascertain whether you are liable to register/renew your registration Certificate under section 8 of the Goa Tax on Entry of Goods Act, 2000/Rule 4 of the Goa Tax on Entry of Goods Rules, 2000.
Whereas I desire to satisfy myself that the return/statement(s) furnished by you in respect of the period from ...................to ………………….. is correct and complete.
Whereas I am of the opinion that though you are liable to furnish the return under section 14(1), Rule 11(1) or statement(s) under section 18(1)/Rule 8(1) you have failed to furnish it.
Whereas I desire to satisfy that the books of accounts maintained by you for the period from .................... to .............................. are true and correct and are in accordance with the Rules, you are hereby requested to appear in person before me or arrange to represent you before me by a legal practitioner or a duly authorised representative at…………………..
(place) .................................. (time) on…………………………(date) add to produce the following documents before me:
(1) All your account books and registers, sale bills, purchase vouchers, sale/purchase advices, declarations, delivery notes relating to purchases, sales deliveries and stock of goods.
(2) Any other document containing information relating to your business.
You are also informed that failure to comply with the terms of this notice is an offence punishable under Rule 41.
Place: Signature Assistant/Entry Tax Officer Date:
- 41 - FORM 21 [See rules 11 (5) and 25(2)] Refund Payment Order Book No. Voucher No.
Counterfoil order for the refund of tax/penalty under the Goa Tax on Entry of Goods Act,
2000.
(1) Refund payable to .....................................................................................…………
(2) Registration Certificate No. ................................................................…………….
(3) No. and date of order directing refund ………………………………………………
(4) Year of assessment to which refund relates .............................................................
(5)Amount of refund .................................................................
Place:
Date:
Designation Signature Asst./Entry Tax Officer Signature of the receipient of Refund Payment order Date of encashment of the Refund payment order ……………………………… - 42 - FORM 21 [See rules 11(5) and 25(2)] Refund Payment Order Book No. Voucher No.
Order for the refund of tax/penalty under the Goa Tax on Entry of Goods Act, 2000.
Payable at the Government Treasury/Bank within three months of the date of issue.
To, ……………………………………………………………………………………………… The Treasury Officer ............................................................................................................
Manager ............................................................................................................................. ....
(1) Certified that with reference to the assessment records of assessee ……………………..whose Registration Certificate No. is ......................... for the period from …………………… a refund of Rs. ………………………………. is due.
(2) Certified that the amount concerning which this refund is allowed has been duly credited to the Government Treasury.
(3) Certified that no refund payment order/refund adjustment order regarding the sum now in question has previously been granted.
(4) Certified that this refund payment order has been entered in the original file of assessment under my signature.
Please pay to ................................................ a sum of Rs. ……………………… (figures) (Rupees. ................................ in words).
Place: Signature Date: Designation Particulars of encashment in Government Treasury/Bank……………………………paid Rs. .................................... this day .........................
Place: Signature Date: Designation - 43 - FORM 22 [See rules 11(5) and 25(2)] Refund Adjustment Order Name and address of the assessee ........................... Registration Certificate No. under the Goa Tax on Entry of Goods Act, 2000 ..........................
(1) Certified with reference to the assessment record of the assessee for the period from ………………. to ............ a refund of Rs............ (figures) Rupees…………………… (in words) is due.
(2) Certified that the amount concerning which this refund is allowed has been credited to the Treasury.
(3) Certified that no refund payment order/refund adjustment order regarding the sum in question has previously been granted and that this order of refund adjustment has been entered in the original file of assessment under my signature.
(4) This refund is adjusted towards the amount of .................. due from the said refund for the period from .……………........ to ............................
Place: Signature Date: Designation, Asst./Entry Tax Officer - 44 - FORM 23 [See rule 14] Application for permission to pay finally assessed tax under the Goa Tax on Entry of Goods Act, 2000, in instalments To, .................................
.................................
.................................
I, ..................., son of ............................. being an assess ...... under the Goa Tax on Entry of Goods Act, 2000 hereby apply for permission to pay in instalment the finally assessed tax due from me as per the following details:
(1) Name and address of the applicant
(2) Registration No. (if any)
(3) Sum of payment of finally assessed tax for which instalments are sought
(4) If the sums in column 3 are payable under an order of assessment, the date of service of Notice in Form-10
(5) The period within which permission to pay the sum in column 3 is sought
(6) Reasons for the applicant’s inability to pay the tax/other amount due within the due date
(7) Any other relevant information which the applicant may desire to furnish DECLARATIONS
(a) I hereby declare that to the best of my knowledge and belief the information contained in the above application is true and correct.
(b) I hereby declare that no application for instalment has been made to any other authority in regard to the sums mentioned in column 3.
(c) I hereby declare that no sums other than those mentioned in column 3 are due from me on the date of making this application.
(d) I hereby undertake to pay interest at the rate of 18 per cent. per annum along with each instalment on the sums remaining unpaid from time to time.
(e) I hereby undertake to furnish necessary security to the satisfaction of the concerned assessing authority for the recovery of the sums in relation to which the grant of instalments is applied for.
- 45 - Place: Signature of the Assessee, Name and address Date: of the person signing with status and relationship to the Assessee (whether Proprietor, Manager, Director, Partner, etc.)
- 46 - FORM 24 [See rule 12(1)(b)] Declaration to be furnished by a dealer in respect of goods mentioned in First Schedule sold by him to another dealer in the State
(1) I/We ..................being a registered dealer holding Registration Certificate No.
…………………dated ................. under the GTEG Act, 2000 and carrying on business in the name and style of………………………………………………………… at …………………………… (full address) have sold ...... .............. (quantity) of ..............(description of goods) for Rs. ……………………….. to M/s ............ (name with full address) in my/our Bill No. ................dated .........…….
(2) I/We have caused entry of the above goods into the ............ local area ………………. (name of the local area) and I am/we are liable to tax under the GTEG Act, 2000 and we shall pay the same.
*I/We have purchased the above goods from M/s .....................(name with full address) having Registration Certificate No. ................ vide their sale bill No............ dated ............. and the said dealer has stated that he/his seller would be liable to pay tax on the said goods purchased by me, and I am/we are not liable to tax under the GTEG Act, 2000 in view of the declaration furnished by them.
(3) I am/we are on the rolls of................ (specify assessing authority).
Place: Signature Name of the Signatory Date: Proprietor/Partner/Manager/ /Director *Strike out whichever is not applicable.
- 47 - FORM 25 [See rule 12] Register of declaration in Form-19 issued to other dealers within the State Sl.No. Date of issue Sl. No.
of Form- 24 Name and address of the dealer to whom issued Sale Bill No. And date Descriptio n of goods Quantity Value Remarks
(1) (2) (3) (4) (5) (6) (7) (8) (9) _______________________ - 48 - FORM 26 [See rule 27(5)(b)] Entry Tax paid Certificate Sl. No.
Office of the (notified authority) This is to certify that entry tax payable under section 10 of the Goa Tax on Entry of Goods Act, 2000 in respect of the motor vehicle imported from outside the State of Goa described below has been paid vide Challan No. ............ dated …………….. by the importer of the Motor Vehicle No……………, who has imported the Motor Vehicle not for sale within the local area but for own use.
OR This is to certify that the importer of below described Motor Vehicle Shri ……………….. is a registered dealer under the Goa Tax on Entry of Goods Act, 2000 with Registration No. …………………………has paid entry tax payable under section 10 in respect of the Motor Vehicle imported from outside the State of Goa described below vide challan No ......……..… dated …………....… Signature and seal of the Notified Authority Place:
Date:
Class of Motor Vehicle Model Engine No. Chassis No.
(1) (2) (3) (4) - 49 - FORM 27 (Original) (See Rules 38 & 40) (to be retained by the Challan Head of Account: 0042 Taxes on Goods and Passengers Sub Heads: 106 Tax on entry of goods into local areas
01. Tax on entry of goods
02. Other Receipts Challan of Tax, Registration Fee, penalty and composition money paid to the Treasury/Sub-Treasury/State Bank of India/Reserve Bank of India.
For the period from ...............to ............... by whom tendered. (Name and address of the person on whose behalf money is paid ...................... )
(1) Registration No.
(2) Year to which payment relates
(3) Month in which the assessment concluded
(4) In the case of monthly tax, month to which it relates Minor and detailed head (for registered dealers only) Amount in figures
01. Tax on entry of goods:
02. Other Receipts:
i) Registration fee ii) Composition money iii) Penalty iv) Miscellaneous Total ………………….
(to be filled by persons or Departments other than Registered dealers)
01. Tax on entry of goods:
02. Other Receipts:
i) Registration Fee ii) Composition Money iii) Penalty iv) Miscellaneous fee Total:………………...
Signature of Dealer/Depositor - 50 - For use in the Treasury
(1) Received payment of Rs. ................ (in figures) Rupees .......................................
(Date of entry) Accountant Challan No.
Code No. of Treasurer Treasury Officer Treasurer Agent/Manager Stamp of Treasury Note: The duplicate, triplicate and quadruplicate of challan in Form-27 being identical with the original have not been reproduced here. Duplicate to be furnished by the payer to the respective Assessing Authority, triplicate is for the Treasury and the quadruplicate is to be sent by the Treasury to the respective Entry Tax Authority.
- 51 - FORM 28 [See rules 9, 11(1)(a), 11(2), 27(6)] Annual return of turn-over and Tax payable
(1) Return for the year from .................. to ...................
(2) Registration Certificate No. under the Goa Tax on Entry of Goods Act, 2000
(3) Name and full address of the dealer
(4) Style of business
(5) Status of the assessee
(6) Tax payable for the year (as per the table overleaf)
(7) Tax paid (details to be furnished)
(8) Balance due/Excess paid DECLARATION I,. .......................................... do solemnly declare that to the best of my knowledge and belief the information furnished in the above return is true and complete and that it relates to the year covering the period from ............... to .........
Place : Signature Name of the Signatory Date: Proprietor/Partner/Manager/Director Details of the purchase value of Scheduled Goods dealt in during the year and Tax payable Sl.
No Description of the goods n of the goods Value of goods purchased/ /received (both from within and outside local area and motor vehicles imported from outside the State) Value of goods purchase d// from within the local area Value of goods purchased/ /received from outside the local area, but returned to the suppliers Value of goods purchase d/ /received From outside the local area, but sent out of the local area otherwise than by way of sale [excludingg the amount shown under col. 4 (b)] Purchased value of motor vehicle imported from outside the State on which tax has already been paid by filing statement in Form Total deductions 4(a)+4(b) + 4(c)+4(d) Total value of goods liable to tax (3-5) Rate of tax Tax due (Rs. Ps.)
Total Note: The values indicated should include the carriage inwards in all cases.
Assessment No.
Registration No.
- 52 - FORM 29 [See rule 11(1)c] To, ........................... , ........................... , ………………... .
Take notice that for the year ending ........................ you have submitted a return of turnover in Form-28 showing the tax payable by you as Rs……………after deducting the tax already paid by you under section 18 of the Goa Tax on Entry of Goods, for the said year, a sum of Rs. ............... (in words)................... is still payable by you which amount you should have paid on or before ............................... the dates onwhich you submitted the return. You are hereby called upon to pay the said amount alongwith penalty under subsection (2) of section 19 within thirty days from the date of service of this notice on you, by remittance to the Government Treasury in Form 27 at failing which the amount and the said penalty will be .................................................... recovered in the manner specified .................................................................... in sub-section (4) of section 19 of the Goa Tax on Entry of Goods, 2000.
Assessing Authority Seal Place:
Date:
Strike out whatever is not applicable.
- 53 - FORM 30 (See rule 34) Declaration regarding the person(s) authorised to sign document(s) I/We, ..........................of....................carrying on the business under the name and style of........at.........and other places in the State of Goa, namely……………… and liable to pay tax under the Goa Tax on Entry of Goods Act, 2000 do hereby declare and authorise the following person(s), namely .....................whose signature(s) is/are appended herein and identified by me/us and who is/are ...............… of the said concern shall be person(s) authorised to sign the returns, statements, applications under the Act on behalf of the aforesaid business concern or to make statements in any enquiry under the Act.
Place: Signature of the declarant, Date: Status of the declarant By order and in the name of the Governor of Goa.
Yvonne Cunha, Under Secretary (Fin. Exp.).
Panaji, 8th September, 2000.
Sl. No. Name Status Signature 1 2 GOVERNMENT OF GOA Notification
31. Liability for payment of tax and penalty in respect of firm, etc., discontinued or dissolved.—- Application for the grant of a Registration Certificate as a dealer under Goa Tax on Entry of Goods Act, 2000 Certificate of Registration Monthly Statement of Tax Details of the value of Scheduled Goods dealt in during the month and Tax payable Return for turnover and Tax payable by an importer of the Motor Vehicle under the Goa Tax on Entry of Goods Act, 2000 Certificate of Exemption from Submission of Returns Proposition Notice Office of the Entry Tax Officer Ward Dated Proposition Notice Year of Assessment:
Registration Certificate No.
Form of Appeal against an order of assessment under section 14 Form of Appeal Memorandum to the Tribunal Form of Memorandum of Cross Objections Security bond for stay of collection of Tax or other amount in dispute Memorandum of Appeal Order under section 33 of Return of clearing, forwarding, transporting, shipping, etc.
Statement to be submitted by owners, of vehicles or boats, etc.
Delivery note Notice calling for Accounts and other Documents Refund Payment Order Refund Payment Order (1) Refund Adjustment Order Application for permission to pay finally assessed tax under the Goa Tax on Entry of Goods Act, 2000, in instalments Declaration to be furnished by a dealer in respect of goods mentioned in First Schedule sold by him to another dealer in the State Register of declaration in Form-19 issued to other dealers within the State Entry Tax paid Certificate Challan For use in the Treasury Annual return of turn-over and Tax payable Declaration regarding the person(s) authorised to sign document(s)