VAT 100 Print

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FORM VAT 100 [See Rules 138] RETURN

Return REF. No.:756896950

1. General Information 1.1)LVO CODE 1.2)Tax Period(Month/Quarter) 1.3)Return Type 1.4)Filing Date 1.5)TIN 1.6)Full Name of the dealer 1.7)Address of the dealer 1.8)Tax invoices issued in the month: 2. Particulars of Turnover Local 2)Total TO 2.1)Ret., disc., lab. chg. etc rel. to sales of the month 2.2)Const. Sales/C.A. Sales 2.3)Tax Coll.(VAT) 2.4)Exempted Sales 2.5)Others 2.6)Taxable TO (Local) [Box 2 less (Box 2.1 to Box 2.5)] Inter State 1113700 3)Total TO(Interstate/Export) 0 3.1)Ret., disc.,lab. chg, etc. 0 3.2)ST / Cons. Sales 0 3.3)Exempted Sales 1113700 3.4)Direct Exports 0 3.5)Deemed Exports (against H-Form) 0 3.6)Sales in Transit (E-I, E-2) 3.7)Sales in the course of import (including High Sea Sales) 3.8)CST Collected 3.9)Taxable turnover (Interstate) [Box No. 3 less (Total of Box 3.1 to Box 3.8)] 4. Net Tax Payable 4.1)Output Tax Payable (Refer Box No.8.3) 4.2)B/f credit of input tax of previous month (Refer Box 4.10) 4.3)Input tax credit (Refer Box No. 11) 4.4)Tax Payable [Box No.4.1-(Box No.4.2+Box No.4.3)] 4.5)Tax deducted at source(Certificate/s Enclosed) 4.6)Tax already paid in the original/revised/corrected return & IT Adjst. of Prev. 6 months 4.7)Balance Tax Payable [Box No.4.4-(Box.No.4.5+Box.No.4.6)] 4.8)Adjustment of any excess credit towards KST/KTEG/KSTECG 4.9)Refund 4.10)Credit/excess payment carried forward 4.11)Net Tax refund as per Inc. Notf. 5. Tax Payment Details Details 5.1)Tax Payable as per Box. No. 4.7 5.2)Interest 5.3)Others 5.4)Total of Box No. 5.1 to Box No 5.3 0 0 0 0 0 0 0 0 0 0 60 JUL-SEP-2011 ORIGINAL 11/10/2011 29390133027 DAKSHAYANI BEEDI SALES 579 2 MAIN RD,KENGERIUPANAGARA BANGALORE-560060

Amount 0 0 0 0 0 0 0 0 0 0 0

Amount 0 0 0 0

6. Details of Local Sales/ URD Purchases and Output Tax/Purchase Tax Payable 6.1)Taxable TO of sales at 1 % 6.2)Taxable TO of sales at 4% 0 6.11)O/p tax Payable(rel. to BNo.6.1) 0 6.12)O/p tax Payable(rel. to BNo. 6.2) 0 0

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6.3)Taxable TO of sales at 5% 6.4)Taxable TO of sales at 13.5% 6.4.1)Taxable TO of sales at 14% 6.5)Taxable TO of sales at 15% 6.6)Others, if any (please specify) 6.7)Taxable TO of URD purc. at 5% 6.8)Taxable TO of URD purc. at 13.5% 6.8.1)Taxable TO of URD purc. at 14% 6.9)Taxable TO of URD purc. at other rate(specify rate) 6.10)Total (Box No.6.1 to 6.9)

0 6.13)O/p tax Payable(rel. to BNo.6.3) 0 6.14)O/p tax Payable(rel. to BNo.6.4) 6.14.1)O/p tax Payable(rel. to BNo.6.4.1) 0 6.15)O/p tax Payable(rel. to BNo.6.5) 0 6.16)O/p tax Payable(rel. to BNo.6.6) 0 6.17)O/p tax Payable(rel. to BNo.6.7) 0 6.18)O/p tax Payable(rel. to BNo.6.8) 6.18.1)O/p tax Payable(rel. to BNo.6.8.1) 0 6.19)O/p tax Payable(rel. to BNo.6.9) 6.20) Total O/p tax payable (6.11 to 0 6.19)

0 0

0 0 0 0

0 0

7. Details of Interstate Sales(ISS) and CST Payable 7.1)Taxable TO of ISS at 1% 7.2)Taxable TO of ISS against C Forms at 2% 7.3)Taxable TO of ISS without C Forms at 1% 7.4)Taxable TO of ISS without C forms at 4% 7.5)Taxable TO of ISS without C forms at 5% 7.6)Taxable TO of ISS without C forms at 13.5% 7.6.1)Taxable TO of ISS without C forms at 14% 7.7)Taxable TO of ISS without C forms at 15% 7.8)Others, if any (Specify Rate of Tax) 7.9)Total (of BNo. 7.1 to 7.8) 0 7.10)O/p tax payable(rel. to BNo. 7.1) 0 7.11)O/p tax payable(rel. to BNo. 7.2) 0 7.12)O/p tax payable (rel. to BNo. 7.3) 0 7.13)O/p tax payable (rel. to BNo. 7.4) 0 7.14)O/p tax payable (rel. to BNo. 7.5) 0 7.15)O/p tax payable (rel. to BNo. 7.6) 7.15.1)O/p tax payable (rel. to BNo. 7.6.1) 0 7.16)O/p tax payable (rel. to BNo. 7.7) 0 7.17)O/p tax payable (rel. to BNo.7.8) 7.18)Total o/p tax payable(Total of 7.10 0 to 7.17) 0 0 0 0 0 0 0 0 0

8.1)Total Output Tax (Total of BNo. 6.20 and BNo. 7.18) 8.2)Output Tax deferred to Industries as per Incentive Notifications 8.3)Net Output Tax Payable (BNo. 8.1 - BNo. 8.2)

0 0 0

9. Details of Purchases and Input Tax

9.1)Net value of purchases at 1% 9.2)Net value of purchases at 4% 9.3)Net value of purchases at 5% 9.4)Net value of purchases at 13.5% 9.4.1)Net value of purchases at 14% 9.5)Net value of purchases at 15% 9.6)Value of URD purc. to the ext. used/sold during the Month/Quarter 9.6.1)B/F from Prev. period 9.6.2)Rel. to Curr.period 9.6.3)Total (9.6.1+9.6.2) 9.7)Others, if any (pl.specify) 9.8)Value of URD purc. to the ext. not used/sold 9.8.1)B/F from Prev. period 9.8.2)Rel. to Curr. tax period 9.8.3)Total (9.8.1+9.8.2) 9.9)Val. of VAT exempted goods. 9.10)value of Purchase from Composition dealer 0 0 0 1084600 9.21)Input tax carried forward (rel. to BNo. 9.8.3) 0 0 0 0 9.19)Input tax (rel. to BNo. 9.6.3) 0 9.20)Input tax (rel.to BNo. 9.7) 0 0 0 9.14)Input tax (rel. to BNo. 9.1) 0 9.15)Input tax (rel. to BNo. 9.2) 0 9.16)Input tax (rel. to BNo. 9.3) 0 9.17)Input tax (rel. to BNo. 9.4) 9.17.1)Input tax (rel. to BNo. 9.4.1) 0 9.18)Input tax (rel. to BNo. 9.5) 0 0 0 0 0

0 9.11)Val of goods imp/purc. in the course of Import/Export/Interstate trade including E-I & E-II 0 purchases 9.12)Val of goods received by stock 0 transfer/consignment transfer 9.13)Total value of purchases (BNo. 9.1 to 9.5, 9.22)Total input tax 1084600 9.7,9.6.2, 9.8.2 and 9.9 to 9.12) (BNo 9.14 to 9.20)

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10. Ineligible Input Tax Credit 10.1)Non-deductible input tax being restricted u/s 11 10.2)Non-deductible input tax-pre-registration purchases u/s 13 of VAT Act 10.3)Non-deductible input tax-under special rebating scheme u/s 14 read with Section 11 10.4)Non-deductible input tax-under partial rebating scheme u/s 17 of VAT Act 10.5)Non-deductible input tax relating to return of goods purchased 10.6)Others, Please Specify 10.7)Total Ineligible Input Tax Credit (BNo.10.1 to 10.6) 0 0 0 0 0 0 0

11. Eligible Input Tax Credit [BNo. 9.22 - BNo. 10.7] Payment Details Remarks: No Previous Payment I/We hereby declare that the particulars furnished above are true and complete in all respects. Date:................. Place:................ Signature:..................................... Name and designation:...................

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