Register VR-II
Statement of Form D-III issued under the Bihar Value Added Tax Ordinance, 2005
[See Rule 10]
1. Name and style of the business: _______________
2. Taxpayer Identification Number of the selling dealer:
3. Period to which the statement relates:
4. Name of the Circle to which the statement relates:
Part - 'A'
During the Quarter
Serial Number No. of
From
To Forms
Number of forms in hand on first day
of the quarter:
Number of forms printed during the
quarter:
*Number of forms issued during the
quarter:
Number of forms in hand on last day of
the quarter:
Upto the Quarter
Serial Number No. of
From
To Forms
Part - 'B'
Name of the press from which the forms were printed: ________________________
Address of the press from which the forms were printed: _______________________
Taxpayer Identification Number, if any, of the press from which the forms were printed:
Part - 'C'
Total value of forms issued during the quarter:
Total tax deposited during the quarter: ____
Remarks:
Verification ______________________________________________ || _______ || _______ ||
I do hereby declare that the above particulars are correct and complete to the best of my knowledge
and belief.
Place:
Date:
Signature
Full Name
Status
* Funish, as an Annexure, dealer-wise utilization statement indicating therein details of sales effected during the
period.