You are on page 1of 10

FORM - XXXVIII Department of Commercial Taxes, Government of Uttar Pradesh [See rule-53(a) of the UPVAT Rules, 2008] Form

of Declaration for import

Original Copy

Form 38 Serial No Date of Issue Assessment Office TIN Name of Dealer Address of Dealer 1. Description of Goods 2. Weight / Measure 3. Quantity 4. Value in Figure 5. Value in Words

2013-2014/18131500359992 12/06/2013 Bhadohi Sector-1, DC 09615302380 Date(w.e.f) M/S HANUMANT ENTERPRISES MIG -22PHASE-1 RAJPURA COLONY BHADOHI 08/05/2008 Date of Expiry 12/09/2013

6. Bill/ cash memo/ challan/ tax invoice number & date 7. Goods Destination Place 8. Name and Address of seller / consignor 9. TIN of seller / consignor

I, -------------------------------------------------------------, the authorized signatory of the above named dealer;do hereby declare that the goods noted above are being imported/received/brought by the aforesaid dealer.

Signature of authorized signatory 1 . Name & address of the Transporter / carrier etc. 2. Service Provider no. of the carrier, if any 3. Carrier/ Truck no. 4. Name & address of Driver 5. Driving License No. 6. Signature of the vehicle driver. Demand No : 13189990073092 Multiple(Original) 1 Printed On : 12/06/2013 22:39:32

FORM - XXXVIII Department of Commercial Taxes, Government of Uttar Pradesh [See rule-53(a) of the UPVAT Rules, 2008] Form of Declaration for import

Second Copy

Form 38 Serial No Date of Issue Assessment Office TIN Name of Dealer Address of Dealer 1. Description of Goods 2. Weight / Measure 3. Quantity 4. Value in Figure 5. Value in Words

2013-2014/18131500359992 12/06/2013 Bhadohi Sector-1, DC 09615302380 Date(w.e.f) M/S HANUMANT ENTERPRISES MIG -22PHASE-1 RAJPURA COLONY BHADOHI 08/05/2008 Date of Expiry 12/09/2013

6. Bill/ cash memo/ challan/ tax invoice number & date 7. Goods Destination Place 8. Name and Address of seller / consignor 9. TIN of seller / consignor

I, -------------------------------------------------------------, the authorized signatory of the above named dealer;do hereby declare that the goods noted above are being imported/received/brought by the aforesaid dealer.

Signature of authorized signatory 1 . Name & address of the Transporter / carrier etc. 2. Service Provider no. of the carrier, if any 3. Carrier/ Truck no. 4. Name & address of Driver 5. Driving License No. 6. Signature of the vehicle driver. Demand No : 13189990073092 Multiple(Second) 1 Printed On : 12/06/2013 22:39:32

FORM - XXXVIII Department of Commercial Taxes, Government of Uttar Pradesh [See rule-53(a) of the UPVAT Rules, 2008] Form of Declaration for import

Original Copy

Form 38 Serial No Date of Issue Assessment Office TIN Name of Dealer Address of Dealer 1. Description of Goods 2. Weight / Measure 3. Quantity 4. Value in Figure 5. Value in Words

2013-2014/18134800359993 12/06/2013 Bhadohi Sector-1, DC 09615302380 Date(w.e.f) M/S HANUMANT ENTERPRISES MIG -22PHASE-1 RAJPURA COLONY BHADOHI 08/05/2008 Date of Expiry 12/09/2013

6. Bill/ cash memo/ challan/ tax invoice number & date 7. Goods Destination Place 8. Name and Address of seller / consignor 9. TIN of seller / consignor

I, -------------------------------------------------------------, the authorized signatory of the above named dealer;do hereby declare that the goods noted above are being imported/received/brought by the aforesaid dealer.

Signature of authorized signatory 1 . Name & address of the Transporter / carrier etc. 2. Service Provider no. of the carrier, if any 3. Carrier/ Truck no. 4. Name & address of Driver 5. Driving License No. 6. Signature of the vehicle driver. Demand No : 13189990073092 Multiple(Original) 2 Printed On : 12/06/2013 22:39:32

FORM - XXXVIII Department of Commercial Taxes, Government of Uttar Pradesh [See rule-53(a) of the UPVAT Rules, 2008] Form of Declaration for import

Second Copy

Form 38 Serial No Date of Issue Assessment Office TIN Name of Dealer Address of Dealer 1. Description of Goods 2. Weight / Measure 3. Quantity 4. Value in Figure 5. Value in Words

2013-2014/18134800359993 12/06/2013 Bhadohi Sector-1, DC 09615302380 Date(w.e.f) M/S HANUMANT ENTERPRISES MIG -22PHASE-1 RAJPURA COLONY BHADOHI 08/05/2008 Date of Expiry 12/09/2013

6. Bill/ cash memo/ challan/ tax invoice number & date 7. Goods Destination Place 8. Name and Address of seller / consignor 9. TIN of seller / consignor

I, -------------------------------------------------------------, the authorized signatory of the above named dealer;do hereby declare that the goods noted above are being imported/received/brought by the aforesaid dealer.

Signature of authorized signatory 1 . Name & address of the Transporter / carrier etc. 2. Service Provider no. of the carrier, if any 3. Carrier/ Truck no. 4. Name & address of Driver 5. Driving License No. 6. Signature of the vehicle driver. Demand No : 13189990073092 Multiple(Second) 2 Printed On : 12/06/2013 22:39:32

FORM - XXXVIII Department of Commercial Taxes, Government of Uttar Pradesh [See rule-53(a) of the UPVAT Rules, 2008] Form of Declaration for import

Original Copy

Form 38 Serial No Date of Issue Assessment Office TIN Name of Dealer Address of Dealer 1. Description of Goods 2. Weight / Measure 3. Quantity 4. Value in Figure 5. Value in Words

2013-2014/18133400359994 12/06/2013 Bhadohi Sector-1, DC 09615302380 Date(w.e.f) M/S HANUMANT ENTERPRISES MIG -22PHASE-1 RAJPURA COLONY BHADOHI 08/05/2008 Date of Expiry 12/09/2013

6. Bill/ cash memo/ challan/ tax invoice number & date 7. Goods Destination Place 8. Name and Address of seller / consignor 9. TIN of seller / consignor

I, -------------------------------------------------------------, the authorized signatory of the above named dealer;do hereby declare that the goods noted above are being imported/received/brought by the aforesaid dealer.

Signature of authorized signatory 1 . Name & address of the Transporter / carrier etc. 2. Service Provider no. of the carrier, if any 3. Carrier/ Truck no. 4. Name & address of Driver 5. Driving License No. 6. Signature of the vehicle driver. Demand No : 13189990073092 Multiple(Original) 3 Printed On : 12/06/2013 22:39:32

FORM - XXXVIII Department of Commercial Taxes, Government of Uttar Pradesh [See rule-53(a) of the UPVAT Rules, 2008] Form of Declaration for import

Second Copy

Form 38 Serial No Date of Issue Assessment Office TIN Name of Dealer Address of Dealer 1. Description of Goods 2. Weight / Measure 3. Quantity 4. Value in Figure 5. Value in Words

2013-2014/18133400359994 12/06/2013 Bhadohi Sector-1, DC 09615302380 Date(w.e.f) M/S HANUMANT ENTERPRISES MIG -22PHASE-1 RAJPURA COLONY BHADOHI 08/05/2008 Date of Expiry 12/09/2013

6. Bill/ cash memo/ challan/ tax invoice number & date 7. Goods Destination Place 8. Name and Address of seller / consignor 9. TIN of seller / consignor

I, -------------------------------------------------------------, the authorized signatory of the above named dealer;do hereby declare that the goods noted above are being imported/received/brought by the aforesaid dealer.

Signature of authorized signatory 1 . Name & address of the Transporter / carrier etc. 2. Service Provider no. of the carrier, if any 3. Carrier/ Truck no. 4. Name & address of Driver 5. Driving License No. 6. Signature of the vehicle driver. Demand No : 13189990073092 Multiple(Second) 3 Printed On : 12/06/2013 22:39:32

FORM - XXXVIII Department of Commercial Taxes, Government of Uttar Pradesh [See rule-53(a) of the UPVAT Rules, 2008] Form of Declaration for import

Original Copy

Form 38 Serial No Date of Issue Assessment Office TIN Name of Dealer Address of Dealer 1. Description of Goods 2. Weight / Measure 3. Quantity 4. Value in Figure 5. Value in Words

2013-2014/18137600359995 12/06/2013 Bhadohi Sector-1, DC 09615302380 Date(w.e.f) M/S HANUMANT ENTERPRISES MIG -22PHASE-1 RAJPURA COLONY BHADOHI 08/05/2008 Date of Expiry 12/09/2013

6. Bill/ cash memo/ challan/ tax invoice number & date 7. Goods Destination Place 8. Name and Address of seller / consignor 9. TIN of seller / consignor

I, -------------------------------------------------------------, the authorized signatory of the above named dealer;do hereby declare that the goods noted above are being imported/received/brought by the aforesaid dealer.

Signature of authorized signatory 1 . Name & address of the Transporter / carrier etc. 2. Service Provider no. of the carrier, if any 3. Carrier/ Truck no. 4. Name & address of Driver 5. Driving License No. 6. Signature of the vehicle driver. Demand No : 13189990073092 Multiple(Original) 4 Printed On : 12/06/2013 22:39:32

FORM - XXXVIII Department of Commercial Taxes, Government of Uttar Pradesh [See rule-53(a) of the UPVAT Rules, 2008] Form of Declaration for import

Second Copy

Form 38 Serial No Date of Issue Assessment Office TIN Name of Dealer Address of Dealer 1. Description of Goods 2. Weight / Measure 3. Quantity 4. Value in Figure 5. Value in Words

2013-2014/18137600359995 12/06/2013 Bhadohi Sector-1, DC 09615302380 Date(w.e.f) M/S HANUMANT ENTERPRISES MIG -22PHASE-1 RAJPURA COLONY BHADOHI 08/05/2008 Date of Expiry 12/09/2013

6. Bill/ cash memo/ challan/ tax invoice number & date 7. Goods Destination Place 8. Name and Address of seller / consignor 9. TIN of seller / consignor

I, -------------------------------------------------------------, the authorized signatory of the above named dealer;do hereby declare that the goods noted above are being imported/received/brought by the aforesaid dealer.

Signature of authorized signatory 1 . Name & address of the Transporter / carrier etc. 2. Service Provider no. of the carrier, if any 3. Carrier/ Truck no. 4. Name & address of Driver 5. Driving License No. 6. Signature of the vehicle driver. Demand No : 13189990073092 Multiple(Second) 4 Printed On : 12/06/2013 22:39:32

FORM - XXXVIII Department of Commercial Taxes, Government of Uttar Pradesh [See rule-53(a) of the UPVAT Rules, 2008] Form of Declaration for import

Original Copy

Form 38 Serial No Date of Issue Assessment Office TIN Name of Dealer Address of Dealer 1. Description of Goods 2. Weight / Measure 3. Quantity 4. Value in Figure 5. Value in Words

2013-2014/18133600359996 12/06/2013 Bhadohi Sector-1, DC 09615302380 Date(w.e.f) M/S HANUMANT ENTERPRISES MIG -22PHASE-1 RAJPURA COLONY BHADOHI 08/05/2008 Date of Expiry 12/09/2013

6. Bill/ cash memo/ challan/ tax invoice number & date 7. Goods Destination Place 8. Name and Address of seller / consignor 9. TIN of seller / consignor

I, -------------------------------------------------------------, the authorized signatory of the above named dealer;do hereby declare that the goods noted above are being imported/received/brought by the aforesaid dealer.

Signature of authorized signatory 1 . Name & address of the Transporter / carrier etc. 2. Service Provider no. of the carrier, if any 3. Carrier/ Truck no. 4. Name & address of Driver 5. Driving License No. 6. Signature of the vehicle driver. Demand No : 13189990073092 Multiple(Original) 5 Printed On : 12/06/2013 22:39:32

FORM - XXXVIII Department of Commercial Taxes, Government of Uttar Pradesh [See rule-53(a) of the UPVAT Rules, 2008] Form of Declaration for import

Second Copy

Form 38 Serial No Date of Issue Assessment Office TIN Name of Dealer Address of Dealer 1. Description of Goods 2. Weight / Measure 3. Quantity 4. Value in Figure 5. Value in Words

2013-2014/18133600359996 12/06/2013 Bhadohi Sector-1, DC 09615302380 Date(w.e.f) M/S HANUMANT ENTERPRISES MIG -22PHASE-1 RAJPURA COLONY BHADOHI 08/05/2008 Date of Expiry 12/09/2013

6. Bill/ cash memo/ challan/ tax invoice number & date 7. Goods Destination Place 8. Name and Address of seller / consignor 9. TIN of seller / consignor

I, -------------------------------------------------------------, the authorized signatory of the above named dealer;do hereby declare that the goods noted above are being imported/received/brought by the aforesaid dealer.

Signature of authorized signatory 1 . Name & address of the Transporter / carrier etc. 2. Service Provider no. of the carrier, if any 3. Carrier/ Truck no. 4. Name & address of Driver 5. Driving License No. 6. Signature of the vehicle driver. Demand No : 13189990073092 Multiple(Second) 5 Printed On : 12/06/2013 22:39:32

You might also like