Professional Documents
Culture Documents
[Application form for registration under Section 69 of The Finance Act,1994(32 of 1994)]
IDENTIFICATION OF BUSINESS REQUIRING REGISTRATION
Name of Applicant : SCREENLINE EMBELLISHERS INDIA PVT LTD
Address of the Applicant : NO. 252,BEHIND YOUNG BRAND APPAREL BUILDING, KATTUPUTHUR VILLAGE, UTHIRAMERUR TALUK,KANCHEEPURAM DISTRICT-603 107.
Allotted
PAN : AAMCS0132N
SCREENLINE EMBELLISHERS (INDIA) PRIVATE LIMITED
Registered Private Limited Company
Service Recipient
Centralized Registration for more than one premises
Tour operator services
PONDICHERRY
(Puducherry)
Range : MADURANDAGAM-I
TAMIL NADU
9940478843
pradeep@ksaca.com
VILLUPURAM
In case of application for Centralized Registration,furnish address of all the premises from where taxable services are provided or intended to be provided
Name Of Premises/ BRANDIX-APSEZ
Building :
Road / Street / Lane : PUDIMADAKA ROAD
Block / Taluk / Sub- APSEZ
Division / Town :
City / District : VISAKHAPATTINAM
PIN : 531011
Phone Number-2 :
Fax Number-2 :
Premises Code :
Address of the premises or office paying service tax under centralised billing or centralised accounting under
sub-rule (2) and (3A) of rule 4 of the Service Tax Rules,1994
Name Of Premises/ YOUNG BRAND APPAREL
Building :
Road / Street / Lane : UTHIRAMERUR-CHENGELPET
ROAD
Block / Taluk / Sub- UTHIRAMERUR TALUK
Division / Town :
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Address of the premises or office paying service tax under centralised billing or centralised accounting under
sub-rule (2) and (3A) of rule 4 of the Service Tax Rules,1994
City / District : KANCHEEPURAM
PIN : 603107
Phone Number-2 :
Fax Number 2 :
Premises Code :
NAME, ADDRESS AND PHONE NUMBER OF PROPRIETOR / PARTNER / DIRECTOR / TRUSTEES ALONG
WITH DETAILS OF AUTHORIZED SIGNATORIES
Name : NISHANTHA KUMARA
Designation : Director
Address : NO. 18/04, "SCREENLINE HOUSE", THALWATTE,GONAWALA,KELANIYA,SRILANKA
Phone Number : 7299950042
Email Address : pradeep@ksaca.com
Name : THANUJA DILHANI
Designation : Director
Address : NO. 18/04, "SCREENLINE HOUSE", THALWATTE, GONAWALA, KELANIYA,SRILANKA.
Phone Number : 7299950042
Email Address : pradeep@ksaca.com
Declaration
I, S. PRADEEP,hereby declare that the information given in this application form is true,correct and complete in
every respect and that I am authorised to sign on behalf of the Registrant.
(a) For new Registration :I would like to receive the Registration Certificate by mail/by hand/E-MAIL
(b) For amendments to information pertaining to existing Registrant :Date from which amendments are made:
Date : 15/09/2014
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