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THE WEST BENGAL VALUE ADDED TAX RULES, 2005

FORM 50A
Way bill for transport of consignment of goods despatched from
Outside West Bengal to any place inside West Bengal
[See rule 100B read with rule 100A,rule 103A and rule 104A]
Original/Duplicate
PART-I Printed On: 22/01/2011 3.47 PM

Waybill Key No. T19201100216193

Date of Issue 22/01/2011

Office of Issue Directorate of Commercial Taxes,West Bengal

a) Name an Address of the Dealer / Person importing the goods

VAT RC No 19432762042

CST RC No. 19432762236

Trade Name KALPENA INDUSTRIES LTD.

Address of principal place of Business 2B,, PRETORIA STREET,, KOLKATA

District-KOLKATA

PIN 700071
State West Bengal
PAN AABCK2239D
b) Name an Address of the Dealer / Person from whom the goods are purchased / imported
VAT RC No 05005724480

CST RC No. HN-5066065

Trade Name Kumaon Georesource Pvt. Ltd.

Address of principal place of Business C/o. Parvatiya, Mines, Dewalcharur,

Rampur Road, Haldwani, Dist. Nainital

PIN 263139
State of India/U.T. of India/ Country other than India UTTARANCHAL

PAN

Signature
Name of the person signing the Waybill

Status of the #person signing the waybill


[in relation to the importing dealer]
#Proprietor/Partner/Director/Authorised Person,etc.

[Seal]

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