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Waybill Serial No.
Waybill Key No. Office of issue
Date of generation of the Waybill in form 50A Valid upto

Original/Duplicate

THE WEST BENGAL VALUE ADDED TAX RULES, 2005

FORM 50A

Printed On: 04/10/2012 8.07 PM

Way bill for transport of consignment of goods despatched from Outside West Bengal to any place inside West Bengal

[See rule 110B read with rule 100A,rule 103A and rule 104A] 192012093553000 T1920120468966604

Directorate of Commercial Taxes,West Bengal

04/10/2012 8.07 PM

04/11/2012

1.Name and Address of the Dealer/Person Importing the goods

a) VAT RC No

19200304064

b)CST RC No

19200304258

 

c)Trade Name

A I CHAMPDANY INDUSTRIES LIMITED

d) Address of principal place of Business

, 18, NETAJI SUBHAS RO, AD, CALCUTTA

 

 

District-KOLKATA

e)PIN

700001

f)PAN

AACCA4860D

2.Name and Address of the Dealer/Person from whom the goods are purchased/imported

a) VAT RC No

 

 

 

b)CST RC No

 

 

 

c)Trade Name

SHAHID & SONS

 

 

d) Address of principal place of Business

DAULATPUR,

 

 

 

KHULNA,

 

 

 

BANGLADESH

 

 

e)PIN

000000

 

 

f)PAN

 

 

 

g)State of India/Union Territory of India/Country

OTHERS

 

 

other than India

 

 

 

 

 

3.Mode of transport of goods in West Bengal

Road

 

 

 

 

 

4.Registration Certificate No. of the Vehicle

WB25D.9886/WB25B.4552/WB15.5835

 

 

 

 

5.Name and Address of the Transporter/Owner of the vehicle by which the goods are transported

a)Name

ARROW ROADLINE

 

 

b)Address

JESSORE ROAD, BONGAON

 

 

 

NORTH 24 PARGANAS

 

 

c)Enrolment No. under the WB VAT Act 2003(if any)

 

 

 

6.Detail of Consignment Note/Railway Receipt/Airway

No. 16882/16883/16884

Date

04/10/2012

Bill/Bill of Landing/ Bill of Entry or similar document

 

 

 

7.Total No. of Invoices/tax invoices/cash memos/bills/challans/forwarding notes(details as per Annexure to

1

8.Total Value of Goods(details as per Annexure to 50 A)

1130330.00

 

 

9.Possible Entry location in W.B

NORTH 24 PARGANAS

 

 

Note a) Name of the District, if transport by road

b)Name of the railway station/port/airport,if transport by rail/sea/air

Declaration-*I/We declare that the information furnished as above are correct to the best of my/our knowledge and belief.

Signature

Name of the person signing the Waybill

Status of the person signing the Waybill [in relation to the importing dealer]. #Proprietor/Partner/Director/Authorised Person, etc

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THE WEST BENGAL VALUE ADDED TAX RULES, 2005

ANNEXURE TO WAYBILL IN FORM 50A

Details of Invoices / Tax Invoices / Cash Memos / Bills / Challans / Forwarding Notes and of goods in relation to Sl. No. 7 and Sl. No. 8 of Waybill in Form 50A

 

 

Original/Duplicate

 

 

 

 

 

 

Printed On: 04/10/2012 8.07 PM

Waybill Serial No

 

192012093553000

 

 

 

Waybill Key No.

 

T1920120468966604

 

 

 

Office of issue

 

Directorate of Commercial Taxes, West Bengal

 

Date of generation of the waybill in Form

04/10/2012 8.07 PM

 

 

 

Valid upto

 

04/11/2012

 

 

 

 

Details of Invoice/tax invoice/cash memo/bill/challan/forwarding note etc. and description,quantity

 

and value of goods

 

 

 

 

 

 

Invoice/bill/challan/for

Invoice Date

 

Commodity

 

Value of

warding note etc.

 

Name

Quantity

Unit

Nos of Packages

Goods

 

 

 

SA/09/12-13

18/09/2012

RAW JUTE.

49.91

METRI

277

1130330.00

 

 

 

 

C TON

 

 

Declaration-*I/We declare that the information furnished as above are correct to the best of my/our knowledge and belief

Signature

Name of the person signing the declaration Status of the person signing the declaration [In relation to the importing dealer]

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