Orignial

FORM  402                                                                                                                                                                                                                                        Form 402(See rule 51)
Declaration under section 68 of the Gujarat Value Added Tax Act, 2003
(For movement of goods within the State or goods moving outside the State)
To,
The officer in charge
Check post……
1. Place From Which Goods are dispatched VADODARA District VADODARA
2. Place to Which Goods are dispatched {DELTYPE} District {DESTINATION}
3. Details of goods invoice No {SINO} Date {SIDATE}
4. Consignor’s details :
Name HydroFiltsep Technologies P Ltd. State Gujarat
Address B-1 Basement, Amarnath Appt., Registration No 24190204032
  B/s Sterling House, Nr. Akota Stadium Date 26-Mar-09
  Akota, Vadodara CST No. 24690204032
Phone No 2321358 Date 26-Mar-09
5. Nature of Transaction :
I Inter state sale   II Transfer of documents of title  
III Depot Transfer   IV Consignment to Branch/Agent  
V For export   VI For Job works/Works contract  
VII Any Other   Consigned Value {AMOUNT}
6. Consignee’s details:
Name {CONSIGNEE} State {STATE}
Address {ADDRESS1} Registration No {VATNO}
  {ADDRESS2} Date
  {ADDRESS3} CST No. {CSTNO}
Phone No {PHONENO} Date
Sr. No. Description of Goods Commodity Code Unit Quantity Rate of Tax Value
1 {ITEM1}   {QTY1} {TAX} % {VAL1}
2 {ITEM2}   {QTY2} {TAX} % {VAL2}
3 {ITEM3}   {QTY3} {TAX} % {VAL3}
4 {ITEM4}   {QTY4} {TAX} % {VAL4}
7. Transporter’s Details
Name   Owner/Partner Name  
Address            
  8. Vehicle No.  
  L.R. No.   Date  
9. Driver’s Details: Name
Address   Driving Licence No.  
       
    Licence issuing State  
person in charge of goods
SEAL Place   Signature:
Date  
     
      Designation Accountant
For Commercial Tax Department/Check post
Entry No.   Reason of abnormal stoppage Result if any
Vehicle Date  Time    
Arrival        
Depart        
Date   Signature Designation  
       
             
             
Duplicate
FORM 402                                                                                                                                                                                                                                   (See rule 51)
Declaration under section 68 of the Gujarat Value Added Tax Act, 2003
(For movement of goods within the State or goods moving outside the State)
To,
The officer in charge
Check post……
1. Place From Which Goods are dispatched VADODARA District VADODARA
2. Place to Which Goods are dispatched {DELTYPE} District {DESTINATION}
3. Details of goods invoice No {SINO} Date {SIDATE}
4. Consignor’s details :
Name HydroFiltsep Technologies P Ltd. State Gujarat
Address B-1 Basement, Amarnath Appt., Registration No 24190204032
  B/s Sterling House, Nr. Akota Stadium Date 26-Mar-09
  Akota, Vadodara CST No. 24690204032
Phone No 2321358 Date 26-Mar-09
5. Nature of Transaction :
I Inter state sale 0 II Transfer of documents of title 0
III Depot Transfer 0 IV Consignment to Branch/Agent 0
V For export 0 VI For Job works/Works contract 0
VII Any Other 0 Consigned Value {AMOUNT}
6. Consignee’s details:
Name {CONSIGNEE} State {STATE}
Address {ADDRESS1} Registration No {VATNO}
  {ADDRESS2} - -
  {ADDRESS3} CST No. {CSTNO}
Phone No {PHONENO} - -
Sr. No. Description of Goods Commodity Code Unit Quantity Rate of Tax Value
1 {ITEM1} 0 {QTY1} {TAX} % {VAL1}
2 {ITEM2} 0 {QTY2} {TAX} % {VAL2}
3 {ITEM3} 0 {QTY3} {TAX} % {VAL3}
4 {ITEM4} 0 {QTY4} {TAX} % {VAL4}
7. Transporter’s Details
Name   Owner/Partner Name  
Address  
  8. Vehicle No.  
  L.R. No.   Date  
9. Driver’s Details: Name  
Address   Driving Licence No.
   
  Licence issuing State
person in charge of goods      
SEAL Place 0 Signature:
Date 00.01.1900
Designation Accountant
For Commercial Tax Department/Check post
Entry No.   Reason of abnormal stoppage Result if any
Vehicle Date  Time    
Arrival        
Depart        
Date   Signature Designation
 
Triplicate
FORM 402                                                                                                                                                                                                                                   (See rule 51)
Declaration under section 68 of the Gujarat Value Added Tax Act, 2003
(For movement of goods within the State or goods moving outside the State)
To,
The officer in charge
Check post……
1. Place From Which Goods are dispatched VADODARA District VADODARA
2. Place to Which Goods are dispatched {DELTYPE} District {DESTINATION}
3. Details of goods invoice No {SINO} Date {SIDATE}
4. Consignor’s details :
Name HydroFiltsep Technologies P Ltd. State Gujarat
Address B-1 Basement, Amarnath Appt., Registration No 24190204032
  B/s Sterling House, Nr. Akota Stadium Date 26-Mar-09
  Akota, Vadodara CST No. 24690204032
Phone No 2321358 Date 26-Mar-09
5. Nature of Transaction :
I Inter state sale II Transfer of documents of title
III Depot Transfer IV Consignment to Branch/Agent
V For export 0 VI For Job works/Works contract 0
VII Any Other 0 Consigned Value {AMOUNT}
6. Consignee’s details:
Name {CONSIGNEE} State {STATE}
Address {ADDRESS1} Registration No {VATNO}
  {ADDRESS2} -
  {ADDRESS3} CST No. {CSTNO}
Phone No {PHONENO} -
Sr. No. Description of Goods Commodity Code Unit Quantity Rate of Tax Value
1 {ITEM1} 0 {QTY1} {TAX} % {VAL1}
2 {ITEM2} 0 {QTY2} {TAX} % {VAL2}
3 {ITEM3} 0 {QTY3} {TAX} % {VAL3}
4 {ITEM4} 0 {QTY4} {TAX} % {VAL4}
7. Transporter’s Details
Name   Owner/Partner Name  
Address  
  8. Vehicle No.  
  L.R. No.   Date  
9. Driver’s Details: Name  
Address   Driving Licence No.
   
  Licence issuing State
person in charge of goods      
SEAL Place 0 Signature:
Date 00.01.1900
Designation Accountant
For Commercial Tax Department/Check post
Entry No.   Reason of abnormal stoppage Result if any
Vehicle Date  Time    
Arrival        
Depart        
Date   Signature Designation