Form GST REG-30
[See rule 25]

Form for Field Visit Report
Center Jurisdiction (Ward/Circle/Zone)

Name of the Officer :- << to be prefilled >>

Date of Submission of Report :-

Name of the taxable person

GSTIN/UIN –

Task Assigned by :- < Name of the Authority- to be prefilled >

Date and Time of Assignment of task :- < System date and time>

Sr. No. Particulars

Input
1. Date of Visit  
2. Time of Visit  
3. Location details    :
         Latitude

Longitude
        North – Bounded By

South-Bounded By
        West – Bounded By

East-Bounded By
4. Whether address is same as mentioned in application.

Y / N
5. Particulars of the person available at the time of visit  
  (i) Name  
  (ii) Father's Name  
  (iii) Residential Address  
  (iv) Mobile Number  
  (v) Designation / Status  
  (vi) Relationship with taxable person, if applicable.  
6. Functioning status of the business

Functioning - Y / N
7. Details of the premises  
      Open Space Area (in sq m.) - (approx.)  
      Covered Space Area (in sq m.) - (approx.)  
      Floor on which business premises located  
8. Documents verified

Yes/No
9. Upload photograph of the place with the person who is present at the place where site verification is conducted
10. Comments (not more than < 1000 characters >

Signature         
Name of the Officer:
Designation:           
Jurisdiction:            

Place:
Date:

[F.No 349/58/2017-GST]

(Dr. Sreeparvathy S. L.)
Under Secretary to the Government of India