3240601001230102159347000

FORM 403
(See sub-rule (5) of rule 51)
(For goods entering into the State from outside the State)

Declaration under Section 68 of the Gujarat Value Added Tax Act, 2003
Form No. 144775087
Date: 12-FEB-2015 02:29:52 PM
To,
The officer in charge
Check post BHILAD
(1) Place to which goods are dispatched : Gujarat
District : KACHCHH
(2) Place from which goods are dispatched : Maharashtra
District : MUMBAI
(3) Details of goods :

Sr. No.

Invoice No.

Invoice Date

028

11/02/2015

(4) Consignees details :

Name

State

Gujarat

Registration No.

24060100123

Date

01/07/2002

Telephone

CST No.

24560100123

Fax No.

Date

05/09/2005

Registration No.

27700276886V

Date

01/04/2006

Address

INDIAN FARMERS FERTILISER CO-OPERATIVE L

A~BAD-MEHSANA HIGHWAY,NR.SAIJ
VILLAGE,KASTURINAGAR,KASTURINAGAR,06,GANDHINAGAR382423

(5) Nature of Transaction : INTERSTATE SALE

(6) Consignors details :

Name
Address

CHETAN STEELS
D5095 BIMA COMPLEX PLOT NO 119 KALAMBOLI

Telephone
CST No.

27700276886C

Date

01/04/2006

Fax No.

Consigned Value Rs.441739

Sr.
No.

Description of Goods

Galvanised pipes of iron or steel other than

those coming under heading 7305

Commodity
Unit
Unit
Rate of Commodity
Code
Quantity Measure
Tax
Value
73061011

313

Nos

Invoice No.

441739

028

(7) Transporters Details :

(a) Name : ASSOCIATED ROAD CARRIERS LTD

(8) Vehicle No : i) 0 ii)
(9) Drivers Details:

L.R.No. :

Date :

(a) Name :
(b) Driving License No. :
(c) License issuing State :
(d) Drivers Signature :
(e) Address :
(10) Name and the address of person in charge of goods __________________________
Seal :
Place: ____________________Date: ____________________Designation: _______________________Signature: _______________________
For Commercial Tax Department/Check post

Entry No.
Vehicle

Reason of Abnormal stoppage

Date

Time

Arrival
Depart
Date: ________________

Designation: _________________

Status: _________________

Result if any