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Application for Registration

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..... ion submitted above is subject to online verification before proceeding to fill up Part-B. 6 [ E-mail Id and Mobile Number shall be auto-populated from Income Tax database as linked with the Permanent Account Number of the applicant ] . Part B 1. Trade Name, if any 2. Constitution of Business (Please Select the Appropriate) (i) Proprietorship __ (ii) Partnership __ (iii) Hindu Undivided Family __ (iv) Private Limited Company __ (v) Public Limited Company __ (vi) Society/Club/Trust/Association of Persons __ (vii) Government Department __ (viii) Public Sector Undertaking __ (ix) Unlimited Company __ (x) Limited Liability Partnership __ (xi) Loc .....

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..... Turnover (Rs.) Net Tax Liability (Rs.) (i) Integrated Tax (ii) Central Tax (iii) State Tax (iv) UT Tax (v) Cess Total Payment Details Challan Identification Number Date Amount 12. Are you applying for registration as a SEZ Unit? Yes No .....

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..... Hotel and Luxury Tax Registration Number Central Excise Registration Number Service Tax Registration Number Corporate Identify Number/Foreign Company Registration Number Limited Liability Partnership Identification Number/Foreign Limited Liability Partnership Identification Number Importer/Exporter Code Number Registration number under Medicinal and Toilet Preparations (Excise Duties) Act Registration number under Shops and Establishment Act Temporary ID, if any Others (Please specify) 16. (a) Address of Principal Place of Business Building No./Flat No. Floor No. Name of the Premises/Building Road/Street .....

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..... Type of Account IFSC Bank Name Branch Address To be auto-populated (Edit mode) Note Add more accounts ------ 18. Details of the Goods supplied by the Business Please specify top 5 Goods Sr. No. Description of Goods HSN Code (Four digit) (i) (ii) (v) 19. Details of Services supplied by the Business. Please specify top 5 Services Sr. No. Description of Services HSN Code (Four digit) (i) (ii) .....

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..... P __ Works Contract __ Export __ Import __ Other Specfy __ 21. Details of Proprietor/all Partners/Karta/Managing Directors and whole time Director/Members of Managing Committee of Associations/Board of Trustees etc . Particulars First Name Middle Name Last Name Name Photo Name of Father Date of Birth DD/MM/YYYY Gender Male, Female, Other Mobile Number Email address Telephone No .....

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..... Are you a citizen of India? Yes / No Passport No. (in case of foreigners) Residential Address in India Building No/Flat No Floor No Name of the Premises/Building Road/Street Block/Taluka City/Town/Locality/Village District State PIN Code 23. Details of Authorised Representative Enrolment ID, if available Provide following details, if enrolment ID is not available Permanent Account Number .....

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..... ern Proprietor (b) Partnership Firm / Limited Liability Partnership - Managing/Authorised/Designated Partners (personal details of all partners are to be submitted but photos of only ten partners including that of Managing Partner are to be submitted) (c) Hindu Undivided Family Karta (d) Company Managing Director or the Authorised Person (e) Trust Managing Trustee (f) Association of Persons or Body of Individuals Members of Managing Committee (personal details of all members are to be submitted but photos of only ten members including that of Chairman are to be submitted) (g) Local Authority Chief Executive Officer or his equivalent (h) Statutory Body Chief Executive Officer or his equivalent (i) Others Person in Charge 2. Constitution of Business: Partnership Deed in case of Partnership Firm, Registration Certificate/Proof of Constitution in case of Society, Trust, Club, Government Department, Association of Persons or Body of Individuals, Local Authority, Statutory Body and Others etc. 3. Proof of Princip .....

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..... d, vide resolution no dated .. (copy submitted herewith), to act as an authorised signatory for the business Goods and Services Tax Identification Number - Name of the Business for which application for registration is being filed under the Act. All his actions in relation to this business will be binding on me/ us. Signature of the person competent to sign Name: Designation/Status: (Name of the proprietor/Business Entity) Acceptance as an authorised signatory I (Name of the authorised signatory hereby solemnly accord my acceptance to act as authorised signatory for the above referred business and all my acts shall be binding on the business. Place: Date: Signature of Authorised Signatory (Name) Designation/Status: .....

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..... the list available on the common portal if the authorised representative is enrolled, otherwise provide details of such person. 6. State specific information are relevant for the concerned State only. 7. Application filed by undermentioned persons shall be signed digitally:- Sr. No Type of Applicant Type of Signature required Sr. No Type of Applicant Type of Signature required 1. Private Limited Company Public Limited Company Public Sector Undertaking Unlimited Company Limited Liability Partnership Foreign Company Foreign Limited Liability Partnership Digital Signature Certificate (DSC)- Class-2 and above. 2. Other than above Digital Signature Certificate class 2 and above e-Signature or any other mode as may be notified 8. All information related to Permanent Account Number, Aadhaar, Director Identification Number, C .....

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