FORM GST ITC-02A
[See rule 41A]
Declaration for transfer of ITC pursuant to registration under sub-section (2) of section 25

1. GSTIN of transferor  
2. Legal name of transferor  
3. Trade name of transferor, if any  
4. GSTIN of transferee  
5. Legal name of transferee  
6. Trade name of transferee, if any  

7. Details of ITC to be transferred

Tax Amount of matched ITC available Amount of matched ITC to be transferred
1 2 3
Central Tax    
State Tax    
Integrated Tax    
Cess    

8. Verification

I __________________________________________ hereby solemnly affirm and declare that the information given hereinabove is true and correct to the best of my knowledge and belief and nothing has been concealed there from.
Signature of authorised signatory _______________________________________
Name _______________________________________
Designation/Status ____________________________
Date---dd/mm/yyyy

Instructions:

1. Transferor refers to the registered person who has an existing registration in a State or Union territory.
2. Transferee refers to the place of business for which a separate registration has been obtained under rule 11.”