FORM ST-1 [Application form for registration under Section 69 of The Finance Act,1994(32 of 1994)]

IDENTIFICATION OF BUSINESS REQUIRING REGISTRATION

Name of Applicant : Perfect Forgings Address of the Applicant : B.I.T-STEP Industrial Estate, Mesra, Ranchi, Jharkhand 835215

Details of Permanent Account Number(PAN) of the applicant

PAN Status : Name of the Applicant(as appearing in PAN) : Constitution Of applicant : Name of Trustee/Proprietor/HUF : Category of Registrant : Nature of registration : Taxable services provided : Allotted PERFECT FORGINGS Proprietorship Kunj Bihari Singh Service Provider Registration of a single premise ADVERTISING SPACE OR TIME PAN : AABFP8636N

ADDRESS OF PREMISES FOR WHICH REGISTRATION IS SOUGHT

Name Of Premises/Building : PERFECT FORGINGS Road / Street / Lane : B.I.T-STEP Industrial Estate, Mesra Block / Taluk / Sub-Division / Ranchi Town : City / District : Ranchi PIN : 834005 Phone Number-2 : 06516451216 Fax Number 2 : 06512275144 Commissionerate : RANCHI Range : RANCHI-I Flat / Door / Block No : 10 Village / Area / Lane : Mesra Post Office : Mesra State / Union Territory : Phone Number-1 : Fax Number-1 : Email Address : Division : JHARKHAND 06516451216 06512275144 kbkunj@gmail.com RANCHI

NAME, DESIGNATION AND ADDRESS OF AUTHORIZED SIGNATORIES

Name : Kunj Bihari Singh Designation : Proprietor Address : B.I.T-STEP Industrial Estate, Mesra, Ranchi, Jharkhand 835215 Phone Number : 06516451216 Email Address : kbkunj@gmail.com

Declaration
I, Kunj Bihari Singh,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 : 30/03/2012

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