FORM ST-1 [Application form for registration under Section 69 of The Finance Act,1994(32 of 1994)]

Application Date: 24/07/2012

IDENTIFICATION OF BUSINESS REQUIRING REGISTRATION

Name of Applicant : ALPHA TRAVELS ( Prop. ARUN BHARTIA) Address of the Applicant : ., 54.4D, HAZRA ROAD, HAZRA ROAD, KOLKATA, WEST BENGAL

Details of Permanent Account Number(PAN) of the applicant

PAN Status : Name of the Applicant(as appearing in PAN) : Constitution Of applicant : Name of Trustee/Proprietor/HUF : Category of Registrant : Nature of registration : Taxable services provided : Allotted ARUN BHARTIA Proprietorship ARUN BHARTIA Service Provider Registration of a single premise Other than in the negative list PAN : ACCPB3755H

ADDRESS OF PREMISES FOR WHICH REGISTRATION IS SOUGHT

Name Of Premises/Building : Road / Street / Lane : Block / Taluk / Sub-Division / Town : City / District : PIN : Phone Number-2 : Fax Number 2 : Commissionerate : 54/4D 54/4D, HAZRA ROAD . KOLKATA 700019 Flat / Door / Block No : . Village / Area / Lane : . Post Office : BALLYGUNGE POST OFFICE State / Union Territory : WEST BENGAL Phone Number-1 : 9330011325 Fax Number-1 : Email Address : abhartia1@hotmail.com Division : SERVICE TAX DIVISON-III - KOLKATA (ST)

SERVICE TAX - KOLKATA

Range : RANGE-II Premises Code :

NAME, DESIGNATION AND ADDRESS OF AUTHORIZED SIGNATORIES

Name : ARUN BHARTIA Designation : Proprietor Address : 93, DESHPRAN SASMAL ROAD, FLAT NO 2/E-4, ASHA APARTMENT, KOLKATA - 700 033 Phone Number : 9330011325 Email Address : abhartia1@hotmail.com

Declaration
I, ARUN BHARTIA,hereby declare that the information given in this application form is true,correct and complete in every respect and that I am authorised to sign on behalf of the Registrant. (a) For new Registration :I would like to receive the Registration Certificate by mail/by hand/E-MAIL (b) For amendments to information pertaining to existing Registrant :Date from which amendments are made: Date : 24/07/2012

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