Form VAT - 47A [See rule 53(1)] DECLARATION FOR IMPORTS BY REGISTERED DEALER Form No.

: Date of Issue : Declared and Certified that the goods, particulars of which are given below, have been imported by me / us from outside the State for purposes mentioned in rule 53, and hold myself / ourselves liable for payment of tax as per law to the Government. (1)Name of Consignee : (2) Registration No. TIN : (3)DETAILS OF IMPORTS Name of Consignor 1 Registration No. (TIN) 2 Invoice / Bill / Dispatch Memo GR.(Bilty) Value / Name of No. Date No. Date Estimated Commodity Value(in Rs.) 3 4 5 6 7 8

(4)Registration No. of the Vehicle :