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Quarterly return for registered person opting for composition levy

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..... (b) ARN Auto (after filing) (c) Date of ARN Auto (after filing) 4. Inward supplies including supplies on which tax is to be paid on reverse charge GSTIN of supplier Invoice details Rate Taxable value Amount of tax Place of supply (Name of State/UT) No. Date Value Integrated Tax Central Tax State/UT Tax CESS 1 2 3 4 5 6 7 8 9 10 11 4A. Inward supplies received from a registered supplier (other than supplies attracting reverse charge) .....

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..... Interest paid, if any Auto Auto Auto Auto Auto 6. Tax rate wise details of outward supplies / inward supplies attracting reverse charge during the year (Net of advances, credit and debit notes and any other adjustment due to amendments etc.) Sr. No . Type of supply (Outward/ Inward) Rate of tax (%) Value Amount of tax Integrate d tax Central tax State/ UT tax Cess 1 2 3 4 5 6 7 8 Auto Auto Auto Auto Auto Auto Auto Auto .....

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..... 1 2 3 4 5 6 7 (a) Integrated tax (b) Central Tax (c) State/UT Tax (d) Cess Bank Account Details (Drop Down) Verification I hereby solemnly affirm and declare that the information given herein above is true and correct to the best of my knowledge and belief and nothing has been concealed therefrom. Signature of Authorised Signatory Name of Authorised Signatory Designation /Status Place Date Instructions:- 1. Terms used: (a) GSTIN: Goods and Services Tax Identification Nu .....

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..... x State/UT Tax 1 2 3 4 6. Substituted vide Notification No. 03/2019-Central Tax dated 29-01-2019 w.e.f. 01-02-2019 before it was read as Quarter Rate Original details Revised details Turnover Central Tax State/UT tax Turnover Central Tax State/UT Tax 1 2 3 4 5 6 7 8 7. Substituted vide Notification No. 31/2019 Central Tax dated 28-06-2019 w.e.f. 28.6.2019 before it was read as Form GSTR-4 [See Rule 62] Quarterly return for registered person opting for composition levy Year Quarter .....

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..... 5. Amendments to details of inward supplies furnished in returns for earlier tax periods in Table 4 [including debit notes/credit notes and their subsequent amendments] Details of original invoice Revised details of invoice Rate Taxable value Amount Place of supply (Name of State/UT) GSTIN No. Date GSTIN No. Date Value Integrated Tax Central Tax State/UT Tax Cess 1 2 3 4 5 6 7 8 9 10 11 12 13 14 5A. Supplies [Information furnished in Table 4 of earlier returns]-If details furnished earlier were .....

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..... 8. Consolidated Statement of Advances paid/Advance adjusted on account of receipt of supply Rate Gross Advance Paid Place of supply (Name of State/UT) Amount Integrated Tax Central Tax State/UT Tax Cess 1 2 3 4 5 6 7 (I) Information for the current quarter 8A. Advance amount paid for reverse charge supplies in the tax period (tax amount to be added to output tax liability) 8A(1). Intra-State supplies (Rate-wise) 8A(2). Inter-State Supplies (Rate-wise) 8B. Advance amount on which tax was paid in earlier period but invoice has been received in the current period [reflected in Table 4 above] (tax amount to be reduced from ou .....

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..... Other Debit Entry Nos. 1 2 3 4 5 6 7 (a) Integrated tax (b) Central Tax (c) State/UT Tax (d) Cess Bank Account Details (Drop Down) 13. Debit entries in cash ledger for tax /interest payment [to be populated after payment of tax and submissions of return] Description Tax paid in cash Interest Late fee 1 2 3 4 (a) Integrated tax (b) Central Tax (c) State/UT Tax (d) Cess Verification .....

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