FORM VAT - 50

[See rule -19(3)(f) & 54(2)]

STATEMENT OF INTER-STATE SALES/USED FORM VAT-49
(All the entries should be filled in capital letters)

Assessment Year - Registration No. (TIN)

Quarter to which statement relates: First Second Third Fourth

1. Name of Dealer

2. Address
Bldg. No/ Name/ Area
Town/City
District (State)
Pin Code Email Id
Telephone Number(s) FAX No.

3. Details of Goods sold / Dispatched

S. Dealer / person to whom Serial No. of

No. goods sold/ dispatched Particulars of goods sold or dispatched used form
Name & Reg. No. No. of Date. Name of Goods Value/ VAT-49
Address (TIN) Invoice/ Estimated
Challan value (in Rs.)

Place : Signature
Date : Name :
Status :

Declaration
I declare that the facts stated above are true to the best of my knowledge and belief and
nothing has been concealed.

Place : Signature
Date : Name :
Status :

ACKNOWLEDGEMENT

Received from M/s _____________________________________________________________

Registration No.(TIN) Form VAT-49 for the quarter
____________ with enclosures mentioned therein.

Serial No. Receipt Register Signature of Receiving Official with date

& seal of office