To be submitted by Existing Assessee Registered With Service Tax Department

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..... de! Registration Code): 1. Division: (Please tick) 2. Range: (Please mention Range Number) _________________ 3. Email id: _____________________________ 4. Repeat Email id: _______________________ .....

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..... _______ to sign this declaration and the contents of this declaration are true and correct. (Signature) Name: ___________________ Designation:___________________ Date:_________________________ To .....

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