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		Signature                              
		 
		Name                                  
		 
		Designation                          
		 
		Jurisdiction                           
		 
		Address                              
		 
		Note - 
		1. Only applicable fields may be filled up. 
		2. Column nos. 2, 3, 4 and 5 of the above Table i.e. tax rate, turnover 
		and tax period are not mandatory. 
		3. Place of Supply (POS) details shall be required only if the demand is 
		created under the IGST Act.”.  |