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Commodity 2
Commodity 3
6.Phone no
7.Cell no
8.Email address
9.Fax Number
10.Website name (if any)
11.PAN
12. TIN* 23193001429
13. Return Period From* 01/04/2022
14. Return Period To* 30/06/2022
15.Mandi-license no and issuing authority
16. Mining-license no.and issuing authority
17. Latest details of Bank Accounts.(Account no. / MICR code/Bank
name/Branch)
Weight, Volume,Measurement or unit on certain goods PART C-1: Tax by Weight, Volume,Measurement or unit on certain goods
Quantity/Volume in unit as
Turnover of commodity* Description of Goods* Rate of tax(%)* Tax Payable*
Turnover of commodity* mentioned with rate of tax*
VBT
Rs 1 and 50 paisa
0.00 High Speed Diesel 456915.00 685372.50
per litre ###
Rs 2 and 50 paisa
0.00 Petrol 142534.00 356335.00
per litre ###
TOTALC1 0 1041708
Part CAA. Tax payable under sub section (1) of section 9-C
Part CAA1. Freight as per section 9-C (1) (d)
Freight relating to rebate notionally admissible
Part CAA2. u/s 9-C (4) (d)
Part CAA3. Taxable freight (1-2) 0
Part CAA4. Rate
Part CAA5. Tax Payable 0
Part CAB. Amount payable under clause (e) of sub section (4) of section 9-C
Part CAB1. Amount deduced U/S 9-C (4) (a)
Amount equal to rebate notionally admissible
Part CAB2. u/s 9-C (4) (d)
Part CAB3. Amount payable (1-2) 0
Part CAC. Total Amount Payable [(A) +(B)] 0
PART E: Input Tax Rebate (on goods other than plant, machinery, equipment and parts thereof)
Rate of Tax Total Turnover* Quantity* Input Tax Rebate
[1]5 [2] [3] [4]
1 AMT 1
4 AMT 4
5 AMT 5
10 AMT 10
13 AMT 13
14 AMT 14
15 AMT 15
16 AMT 16
18 AMT 18
19 36391553.00 6914395.07 AMT 19
20 AMT 20
22 AMT 22
23 AMT 23
25 AMT 25
27 AMT 27
28 AMT 28
29 12628860.45 3662369.53 AMT 29
31 AMT 31
33 AMT 33
35 Rs per cubic meter VOL 35
20 Rs per cubic meter VOL 20
2 Rs 50 Paise per square feet VOL 2.5
1 Rs 50 Paise per square feet VOL 1.5
Rs 4 per litre VOL 4000
Rs 4 and 50 Paise per litre VOL 4500
Rs 3 and 50 Paise per litre VOL 3500
Rs 3 per litre VOL 3000
Rs 2 and 50 Paise per litre 147000.00 367500.00 VOL 2500
Rs 2 per litre VOL 2000
Rs 1 and 50 paisa per litre 453000.00 679500.00 VOL 1500
Rs 1 per litre VOL 1000
50 paisa per litre VOL 500
1 Rs per square feet VOL 1
75 paisa per square feet VOL 0.75
50 paisa per square feet VOL 0.5
PA1Total : 11623765
PART F: Input Tax Rebate (on plant, machinery, equipment and parts thereof)
Rate of Tax1 Rebatable Purchase Price Input Tax Rebate
[1]6
4
5
13
14
15
16
2Total: 0
PART G: Rebate carried forward from previous quarter and other credits
Sr. No. Details Amount
[1]7 [2]
1z ITR Carried Over from previous quarter 2305648.00
Other unadjusted credit (i.e., inventory rebate/disallowed cash
2z 5.00
refund claims in previous quarter)
Total(1+2) 2305653
Note: Transfer of excess ITR is permissible for Canteen Store Department & exempted units only
PART H: Amount of Tax Payable PART I: ITR for Adjustments
[1]8 [2] [3] [1] [2] [3]
Total Input Tax Rebate
1)2 Total Tax(B+C+C1+CA+CB) 11583221 1) 13929418
(E+F+G)
Amount deferred from tax Reversal of Input Tax Rebate
2)2 2) 0
payable (D)
2.a)2 Deferment date 3) Net Input Tax Rebate (1-2) 13929418
3)2 Amount of Tax Exempted 4) Adjustment against VAT
Net Amount Payable (1- Adjustment against Central
4)2 11583221 5)
(2+3)) Sales Tax
Amount of rebate for which
5)2 Interest for Late Payment 6)
cash refund is asked for
Payment Details
Sr. No2 Name of bank* Branch Code* Challan number* Challan Date* Period From Date* Period To Date* Amount*
[1]9 [2] [3] [4] [5] [6] [7] [8]
Total Amount: 0
Total of TDS 0
RAO Refund Adjustment Order(R.A.O) Details (Received from other dealer by transfer of ITR)
RAOY Name of Dealer* TIN* R.A.O. No.* R.A.O. Date * Amount of R.A.O.*
RAOM [1] [2] [3] [4] [5]
RAOI Refund Adjustment Order(R.A.O) Details (Transferred to other dealer on account of excess ITR)
RAOIY Name of other Dealer* TIN* R.A.O. No.* R.A.O. Date * Amount of R.A.O.*
RAOIM [1] [2] [3] [4] [5]
Indian Oil Corporation 23283604186 0.00 453000.00 Rs 1 and 50 paisa per litre 679500.00 Yes No
Indian Oil Corporation 23283604186 0.00 147000.00 Rs 2 and 50 paisa per litre 367500.00 Yes No
[15]
AMT 19
AMT 29.00
VOL 1.50
VOL 2.50
Annexure-1
Dealer wise list of Import Purchases of goods specified in Schedule II
Name of Selling Dealer * TIN* Rate of Tax* Total Purchase*
[1]14 [2] [3] [4]
Name of Purchasing Dealer Name of SEZ TIN Bill No Bill Date Sale Value Declaration (if Any) Mode of Transport
Form 4 as prescribed
Copy of eligibility
in schemes/
certificate
notification
Abstract
(a) Cumulative quantum of tax for the exemption of which eligible
(b) Cumulative quantum of tax, exemption in respect of which has been availed of upto the end of the quarter/year
(c) Balance of cumulative quantum of tax at the end of quarter/ year for the exemption of which eligible (b)-(c)
This is end
Annexure-5
Quantitative details of Mining of Minerals in returns period
Quantity extracted in Location of Mine with Aprox Market
Amount of Royalty Payable
(MT/Cu. Met.) district value
[1]19 [2] [3] [4]