FORM G

Form of Indemnity Bond

(See Rules 12(2) and 12(9))
Know all men by these presents that
We M/s. Pearl Beverages Limited, a Company Registered under the laws of
India and having its registered office at 702, Ansal Bhavan, 16 K.G.Marg,
New Delhi 110 001. Represented by its Authorized Signatory, Mr. R.L.
NarasimhaRao, Director, S/o. Late Sri R.L.Narasimha Murthy registered
dealers/Manufactures under the Central Sales Tax Act, 1956 under
registration No.37870122547 in the state of Andhra Pradesh. (Herein after
called the obligator) is/are held and firmly bound into the President of India
(hereinafter called the Government) in the sum of Rupees 13,66,572.00/(Rupees Thirteen Lakhs Sixty Six Thousand Five Hundred and Seventy Two
Only) we and truly to be paid to the government on demand and without
demur for which payment to be well and truly made. I/we bind
myself/ourselves and my heirs, executors, administrators, legal
representatives and assignees I/we bind myself/ourselves, our successors
and assigns and the persons for the time being having control over my/our
assets and affairs.
Signed this 13th day of August, Two Thousand and Fourteen.

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Whereas rules 21 and 71 of the Central Sales Tax Act 1956, require that in
the event a blank or duly completed form (of Declaration is lost while it is
in the custody of the purchasing dealer or in the transit to the selling
dealer, the purchasing dealer and as the case may be also a selling dealer,
the assessing authority from whom the said form was obtained and in the
case of the selling dealer, the assessing authority of his state and whereas
the obligator is such purchasing/selling dealer.
And whereas the obligator has lost the declaration in Form - C bearing
No.CEAP7309405 dated 21/09/2012 which was duly completed and was
issued to him by Pearl Beverages Limited, Guntur and sent to AMD
Industries Limited, Ghaziabad.
In respect of the goods mentioned below (hereinafter referred to as the
Form).
SL.
NO.

BILL
NO./INVOICE/CHA
LLAN

1.

276

DATE

7-55012

DESCRIPTI
ON OF
GOODS
Pet Preform
Plastic
Bottles

QUANTI
TY
Nos.
1,98,00
0

AMOUNT

Rs.
13,66,572/-

Now the condition of the above written bond or obligation is such that
the obligor shall in the event of loss suffered by the government (in
respect of which the decision of the government or the authority appoints
for the purchase shall be final and binding on the obligator) as a result of
the misuse of the Form pay to the government on demand and without
demur the said sum of Rs.26,796/- (Rupees Twenty Six Thousand Seven
Hundred and Ninety Six Only) and shall otherwise indemnify and keep the
Government harmless and indemnified against and from all liabilities
incurred by the Government as a result of the misuse of such form. Then
the above written bond or obligation shall be void and of no effect but
otherwise shall remain in full force effect and virtue. The obligator further
undertakes to mortgage/charge then properties specified in the schedule
hereunder written by execution or proper deed of mortgage for the
payment of the said sum (whenever called upon to do so by the assessing
authority).

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SCHEDULE
(Give details of property mortgaged/charged)
And these presents also witnessed that the liability of the obligator
hereunder shall not be impaired or discharged by reason of any
forbearance, act of omission of the government or for any time being
granted or indulgence shown by the Government (or by reason of any
change in the constitution of the obligor in cases where the obligor is not
an individual.
The Government aggress to bear the stamp duty if any chargeable on
these presents.
In witness whereof the obligator has set his hand/has caused these
presents executed its authorized representatives, on the duty, month and
year above written.
Signed by the above name obligator in the presence of:-

OBLIGATORS SIGNATURE

Accepted for and on behalf of the Government of Andhra Pradesh in the

presence of:-

NAME AND DESIGNATION OF

THE OFFICER

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