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C01

Year &
Sellers TIN (C03)
(Month or
Quarter)
(YYYYMM or
YYYYQQ)
(C02)

Sellers Name (C04)

Import
from
Outside
India
(C05)

0
1
2
3

0
201444
201444
201444

0.00
###
###
###

201444

5
6
7
8

201444
201444
201444
201444

T
Global Business Enterprises
Goodscour Industrial Co Ltd
Hk Yixiang Import And Export
Limited
Jiangmen City Rainbow Trading
Ltd
Sai International
Sai International
Vishal Trade Concern
Wanda Scouring Commodity Mfg
Co Ltd

07840454067
07840454067
07410305360

###

###

High Seas Own Goods


Purchase Received
(C06)
Back after job
work against
F-Form
(C07)

Purchase from Unregistered


Dealer/Composition Dealer/Non
Creditable Goods/Against Retail
Invoices/Tax free Goods/Labour &
Services related to work contract/Tax
invoices not eligible for ITC/Delhi
dealers against Form-H/Capital
Goods(Used for manufacturing of noncreditable goods) (C08)

Other
Dealer
Received
for job
work
against
F-form
(C09)

Capital
Goods
Purchase
Against
C-Form
(C10)

Goods
(Other than
capital
goods)
purchased
against
C-Forms
(C11)

0.00

0.00

0.00

0.00

0.00

0.00

2074586.00

Inter state
Purchase
against
H-Form
(other
than Delhi
dealers)
(C12)

Inter state
Purchase
without
Forms
(C13)

Inward
Stock
Transfer
(Branch)
against
F-Form
(C14)

Inward
Stock
Transfer
(Consign
ment)
against
F-Form
(C15)

Local
Purchas
e
eligibleCapital
GoodsRate of
Tax
(C16)

Local
Purchas
e
eligibleCapital
GoodsPurchas
e
Amount
(C17)

Local
Purchas
e
eligibleCapital
GoodsInput
Tax Paid
(C18)

0.00

0.00

0.00

0.00

0.00

0.00

0.00

Local
Purchas
e
eligibleCapital
GoodsTotal
Purchas
e
includin
g
Tax
0.00

Type of
Purchas
e (C20)

GD
GD
PTF

Local
Purchas
e
eligibleOthersRate of
Tax
(C21)

Local
Purchas
e
eligibleOthersPurchas
e
Amount
(C22)

Local
Purchas
e
eligibleOthersInput
Tax Paid
(23)

0.00

0.00

0.00

5.00
12.50

###
###

Local
Purchas
e
eligibleOthersTotal
Purchas
e
includin
g Tax
(C24)
0.00

18456.00 ###
42876.00 ###

Rate of
Tax on the
Item
under
Delhi
Value
Added
Tax
Act,2004(
C25)

Does this
purchase
pertain to
dispatches
made by
seller is
previous
Quarter?
(Yes,No)
(C26)

0.00
0.00
0.00
0.00

T
No
No
No

0.00

No

5.00
12.50
0.00
0.00

No
No
No
No

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