4. Name of Circle / Sector - 5. Name / address of the dealer -

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1 UPVAT - XXIV [See Rule-45() of the UPVAT Rules, 008] Return of Tax Period - monthly / quarterly [To be filled in block letters only]. Assessment Year - -. Tax Period Ending on - d d - m m - y y y y. Designation of Assessing Authority 4. Name of Circle / Sector Name / address of the - 6. Taxpayer's Identification Number [TIN] - 6A Taxpayer's PAN (Permanent Account Number ) - 7. Details of [in Rs.] a- Vat Goods i. in own a/c against tax invoice - (annexure-a Part-I ) ii. in own a/c from person other than registered - iii. of exempted - iv. from Ex U.P. - v. in Principal's A/c - - (a) U.P. principal (a-i) against tax invoice (annexure-a Part-II ) (a-ii) Other purchases (b) Ex. U.P. principal vi. Any other purchase - - vii. Less purchase return (annexure A-) - viii. Net amount of purchase - b- Non Vat Goods i. from registered s - ii. from person other than registered - iii. of exempted - iv. from Ex U.P. - v. in Principal's A/c - - (a) U.P. principal (b) Ex. U.P. principal vi. Any other purchase - - vii. Less purchase return (annexure A-) viii. Net amount of purchase Grand - c- Capital Goods purchased from within the State i against tax invoice (Annexure A-) - ii from person other than registered - -

2 d- s through commission agent for which certificate in form VI has been received Sl. Certificate purchased of tax paid 7A. s/ received from outside State against Forms of declaration / certificates (a) against Form C / Form H / Form I - (Details to be furnished in annexure C, D & E respectively) (b) Value of received from outside State against - Form F (details to be furnished in annexure F) - 8. Computation of tax on purchase Sl. Rate of tax Commodity Turnover of Tax Vat Goods i. % ii. 4% iii..5% Additional Tax iv. 0.5% v. % Non Vat Goods vi. vii. viii. ix. x. Grand 9. Details of Sale a- Vat Goods i. Turnover of sale in own a/c against tax invoice (annexure-b Part-I) ii. Turnover of sale in own a/c other than in column- i. - iii. Turnover of sale of exempted - iv. Sales in Principal s A/C - (a) U.P. principal (a-i) Sales against tax invoice (annexure-b Part-II ) (a-ii) Other sales (b) Ex. U.P. principal v. Interstate sale against form 'C' - vi. Interstate sale without form 'C' - vii. Sale in course of export out of India - viii Sale in course of import - ix. Sale outside state - x. Consignment sale /Stock Transfer xi. Any other sale - xii. xiii. Less sales return (annexureb-) Net amount of sales - - -

3 b- Non Vat Goods i. turnover of sale - ii. Exempted turnover of sale - iii. Tax paid turnover of - iv. Sale in Principal's A/c - (a) U.P. principal (b) Ex. U.P. principal v. Any other sale - - vi. Less sales return (annexure B-) vii Net amount of sales Grand - c- Sales through commission agent for which certificate in form V has been received Sl. Certificate sold of tax charged i. ii. iii. 0. Computation of tax on sale Sl. Rate of tax Commodity Sale amount Tax Vat Goods i. % ii. 4% iii..5% Additional tax i. 0.5% ii. % Non Vat Goods i. ii. iii. iv. v. [Vat and Non Vat] Grand. Installment of compounding scheme, if any -. of T.D.S. -. Tax Payable [in rupees] i. Tax on purchase - ii. Tax on sale - iii. Installment of compounding scheme, if any - iv. T.D.S. amount

4 4. Detail of ITC i. ITC brought forward from previous tax period - ii. ITC earned during the tax period - (a) On purchases made in own account (b) On purchases made through purchasing commission agent against certificate in form VI (c) Installment of ITC on opening stock due in the tax period (d) Installment of ITC on capital due in the tax period - (e) ITC reversed during the tax period iii. (f) Admissible ITC in the tax period (a+b+c+d-e) (a) Adjustment of ITC against tax payable - (b) Adjustment of ITC against CST iv. ITC carried forward to the next tax period, if any Net tax i. tax payable (serial no. ) - ii ITC adjustment [4 (vii)] - iii Net tax - 6. Detail of tax deposited A- Tax deposited in Bank / Treasury Name of the bank / branch T.C. number of tax B- By adjustment against adjustment vouchers Adjustment Voucher of tax C- tax deposited (A+B) In figures In words Annexure- - Annexure A / A- / A- / B / B-/C/D/E/F whichever is applicable. - Treasury Challan number / date. DECLARATION I.S/o,D/o,W/o/.Status.[i.e. proprietor, director, partner as provided in rule-(6)], do hereby declare and verify that, to the best of my knowledge and belief all the statements and figures given in this return are true and complete and nothing has been willfully omitted or wrongly stated. - Signature - Place - Status

5 (i) Name and address of purchasing UPVAT - XXIV Annexure - A [See Rule-45() of the UPVAT Rules, 008].List of purchases made against tax invoice : (ii) TIN (iii) Assessment year - Tax period ending on d d m m y y y y of selling TIN in own account Taxinvoice of Tax Description of commodity invoice Name Code / Measure of tax Part-I amount of taxinvoice of selling TIN in commission account Taxinvoice of Tax Description of commodity invoice Name Code / Measure of tax Part-II amount of taxinvoice

6 (i) Name and address of purchasing UPVAT - XXIV List of Returns. Annexure A- (ii) TIN (iii) Assessment year - Tax period ending on d d m m y y y y of selling TIN Tax-invoice / Sale invoice/ invoice Details of purchase returned Name of commodity of tax VAT Non VAT of Tax (+) Sl.no. of debit note issued Sl.no. of credit note received VAT (8+9) Non VAT (v) amount of returned which were purchased against Tax invoice Rs (vi) of Tax involved in such Rs - 6 -

7 (i) (ii) TIN Name and address of purchasing UPVAT - XXIV Annexure A- [See Rule-44() of the UPVAT Rules, 007] List of purchases of Capital made from within the State (iii) Assessment year - Tax period ending on d d m m y y y y 4 5 A-List of purchases of Capital made against tax invoice Name and address TIN Taxinvoice of selling of Tax Description of commodity invoice Name / Measure B-List of purchases of Capital made from persons other than registered Description of commodity invoice of of tax paid with Name / Measure invoice return of tax amount of taxinvoice

8 (i) Name and address of selling UPVAT - XXIV Annexure - B (See Rule-45() of the UPVAT Rules, 008).List of sales made against tax invoice : (ii) TIN (iii) Assessment year - Tax period ending on d d m m y y y y of purchasing TIN Sales in own account Taxinvoice of Tax Description of commodity invoice Name Code / Measure of tax Part-I amount of taxinvoice of purchasing TIN Sales in commission account Taxinvoice of Tax Description of commodity invoice Name Code / Measure of tax Part-II amount of taxinvoice - 8 -

9 (i) Name and address of selling UPVAT - XXIV Annexure B- List of Sales Return. (ii) TIN (iii) Assessment year - Tax period ending on d d m m y y y y of selling Details of sales returned TIN Tax-invoice / Sale invoice/ invoice No Name of commodity of tax VAT Non VAT (8+9) VAT of Tax (+) Sl.no. of credit note issued Sl.no. of debit note received Non VAT (v) amount of returned which were sold against Tax invoice Rs (vi) of Tax charged on such Rs - 9 -

10 Sl. Name of the seller UPVAT - XXIV Annexure - C (Information to be furnished along with return of each tax-period in relation to purchases against Form-C) TIN Address State order no. order date Invoice Invoice date Description of CST Invoice Value Form-8 Purpose of purchase of (write code*) * Write for resale, for use in manufacture/ processing of for sale, for mining, 4 for use in generation/ distribution of power, 5 for use in packing of for sale/resale and 6 for use in Telecommunication network. Sl. Name of the Consigner UPVAT - XXIV Annexure - D (Information to be furnished along with return of each tax-period in relation to received from out side State against Form-F) TIN Address State Details of challan / invoice/ other document under which the were sent Description of or weight Value of Name of Railway Station/ Post office/ Airport/ Transport Co.'s office from which the were Details of RR/GR/Postal receipt any other document indicating the means of transport dispatched on which the were received by the transferee

11 Sl. Name of the Seller UPVAT - XXIV Annexure - E (Information to be furnished along with return of each tax-period in relation to purchases against Form-H) TIN Address State order order date Seller's bill/ Challan/ Cash memo Seller's bill/ Challan/ Cash memo date Description of Value Details of Export Order/ Agreement date Name of Airport/ Sea port/ land customs station of export Name of airline/ Ship/ railway / vehicle or other means of export Details of consignment note/ bill of lading/ railway receipt or any other document in proof of export No Description of exported quantity of exported by the document referred to in column 7/8 Value of referred to in column UPVAT - XXIV Annexure - F (Information to be furnished along with return of each tax-period in relation to purchases against Form-I) Sl. Name of the Seller TIN Address State order no order date Invoice / Challan no. Invoice / Challan date. Description of Value of

1- Assessment Year 2 0-2 0. 2- Assessment Period beginning from D D M M Y Y Ending on D D M M Y Y

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