M. R. Sureka & Co.

Weights & Measurement Consultants

Forms for Cess (Local Body Tax)

Note : Kindly check with Municipal authorities for latest changes. These forms are for indicative purposes for LBT (Local body Tax) or known as CESS applicability.

FORM -A

[See Rule 9(4) and 9(6)]

Application for Registration

1.Name of the applicant (In block letters).……………………………………………………………

2. Status of the applicant ………………………………………………………………………………
(Proprietor/Partner/Karta of the H.U.F./
Manager/ Director/ Secretary/ Principal Officer etc.)
3. Business Name (In block letters) ……………………………………………………………………
4. Date of commencement of business………………………………………………..…………….
5. Full address of the principal place of business……………………….. …………………………
…………………….…………………………………………………………………………………..
…………………………………………………………………………..Pin code………………….
6. Constitution of the business………………………………………………………………………….
(Proprietary /Partnership/H.U.F /Pvt Ltd Co/LTD Co. /Co-op. Society)
7. Nature of business (Manufacturer/ Reseller/Others, specify………………………………….
8. Commodities dealt in (General description)……………………………………………………..
9. Address of the additional place/s of business, if any. ……………………………………….
………………………………………………………………………………………………………….
………………………………………………………………………………………………………….
10. Telephone No. (with S.T.D. Code)…………………………………………………..
11. Fax No. …………………………………………
12. E-mail address……………………………………
13. Details of Bank Account:-
Sr.
No.
Name of the Bank Name of the Branch Account No

14. Registration No. under Maharashtra Value Added Tax Act….………… dated………………
15. Certificate No. under the Shop and Establishment Act………………… dated……………..
16. Income Tax PAN No…………………………………………………………..
17.The name and permanent residential address/es of the proprietor/all partners of the
business/all members of the managing committee of the society, club or other association/all
persons having any interest in the business (including the members of a Hindu undivided
family business), their age and father’s name, is as under:Sr.
No. Name in Full Age Permanent residential address
1
2
3
4
5

(If the names are more than five, a separate sheet with the above particulars, duly signed and dated by the
applicant, should be affixed to this)

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18. The application for registration under the Bombay Provincial Municipal Corporation
(Local Body Tax) Rule, 2010 is being made.(
1). (a) as an ‘importer,’ as the turnover of all the sales / purchases (strike out whatever is
not applicable), first exceeded the limit prescribed under clause (a) of rule 3, during the year
commencing on 1st April ……… (mention here the year), on …………….. (mention here the
date on which such turnover exceeded the prescribed limit). The particulars of the turnover
are as under:

(i) Value of goods imported into the City from………….to…………. Rs………….
(ii) Value of schedule A goods purchased/sold from ……….to……… Rs…………
(iii) Value of (taxable and tax-free) goods sold /purchased from………to……….Rs……….
(b) as ‘others,’ as the turnover of all sales / purchased exceeded the limit prescribed
in clause (b) of rule 3 in the year commencing on 1stApril………..( mention here the year) on
…………………(mention here the date on which the turnover exceeded the prescribed limit).
The particulars of the turnover being as under.(
i)value of schedule -A goods purchased/ sold from ………to………….Rs……….
(ii)value of goods (taxable and tax-free) purchased/sold from………to……..Rs………

(2) on account of ;
(a) change in constitution from *proprietary business to partnership business/
partnership business to proprietary business/ proprietary/partnership to Pvt Ltd Co/ Ltd Co.
(* strick out whichever is not applicable) with effect from……………………
(b) part transfer of business/ transfer of the entire business having Local Body Tax
registration No…………..,…………. w.e.f………………
(3) as a successor in business having local body tax registration
No…………………..w.e.f………………., under clause *(a) of sub-rule(1) / *sub-rule(5) of rule 5
of these rules(*strike out whatever is not applicable).
The above statements are true to the best of my knowledge and belief.

Place; Signature

Date; Status

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19. Declaration by the partners of a firm;
We the within signed, hereby declare that we are carrying on the business in partnership
known as …………………… at………………………………………………………………and
other places in the City and we state that the statements contained in the application for
registration of the said partnership firm and this declaration are true to the best of our
knowledge and belief.

Sr.
No
Full name of each
partner including his
name, father’s name
and surname.
Permanent
residential address
Extent of
share in
partnership
Name and
address of
all other
local
businesses
in which
the partner
has any
share or
interest.
Signature.

Place: Signature
Date : Status

(For office use only)

Date on which called ………………………………..
Place at which called ………………………………..
Officer before whom called………………………….

Signature of the receiving Officer.

ACKNOWLEDGEMENT

Received an application for registration, in form -A from…………………………………………
under rule 9 of the local body tax rules.
Sr. No………..
Date on which called ………………,
Place at which called ……………….
Officer before whom the applicant is called for verification of accounts ……………………….

Date Receiving Officer.

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FORM B

[See rule 10(1)]

Certification of Registration

No.……………………

This is to certify that Shri/Messers………….………………………………………………….
who/which is carrying on the business know as………………………………………….. whereof
the only/chief place of business in the City is situated at
(address)…………………………………………………………………………………………………………….
………………………………………………………………………………………………………………………………….,
has been registered as a dealer under rule 9 of the Bombay Provincial Municipal Corporation
(local body tax) Rules,2010 with effect from……………………………………………

This dealer deals this Business wholly/mainly/Partly in …………………………………
classes of goods (general description).

This dealer has additional places of business at the address specified bellow:Additional
place of business:

(a) Other than warehouses…………………………………………………………,
(b) Warehouse………………………………………………………………………..
This dealer carries on the bellow mentioned activity of processing on job work basis:…………………………………………………………………………………………………
…………………………………………………………………………………………………
…………………………………………………………………………………………………
……………………………………………………………………………………………..
Sr. No.
SEAL
Place:………………………… Signature
Date:………………………… Designation

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FORM C

[(See rule 17 (2)]

Application for Cancellation of Certificate of Registration

To,
The Commissioner,
Municipal Corporation,__________________.

I,________________________________________________________________am

a_____________________________________(Mention here the status of the person signing the

application), on behalf of_______________________________________________(State here
the name of the firm co. etc.). who is carrying on business of___________________________(state
here the nature of business), holding a certificate of registration bearing
number______________________ under the local body tax Rules, whose only / chief place
of business in the City is situated at (Full
address)__________________________________________________________________________
____________________________________________________________________hereby
apply for the cancellation of the said certificate or registration under rule 10 of the local body
tax Rule on account of

*(a) The said business having been discontinued with effect from_______________

*(b) The turnover of sales and the turnover of purchases of the business during the
year______ having failed to exceed the limits specified in the rule 3 of the local body tax
Rules, as per following details:

Turnover of all sales in all places
of business in the city
Turnover of all places
of business in the city
———————————————————————————–
Period
Value of goods
goods imported
Rs.
Taxable goods
Rs.
Non-taxable goods
Rs.
Taxable goods
Rs.
Non-taxable
Rs.
(1) (2) (3) (4) (5) (6)

*(c) The Said business having been transferred in accordance with sub-rule (5) of
rule 5 with effect from_________to Messer’s_______________________________________
*(d) The following changes having been effected in the ownership of the business :

*(e) The said business having been disposed of wholly as under:

*(f) The additional place of business having been discontinued with effect
from_____________________________________________________________

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(g) The place of business having been shifted to the following address:(
h) The following other reason: The
original certificate of registration is enclosed herewith.

In case the original Certificate is not enclosed, state the
reason____________________________________________________.
I,__________________________________________________________,do hereby

declare that what is stated herein is true to the best of my knowledge and belief.

Place : ___________ **Signature
Date: ____________ Status

* Strike out whichever is not applicable.
** To be signed by dealer or any person duly authorized by him.
ACKNOWLEDGMENT

Received an application in From C, signed by -
Shri.______________________________________________________________________
dated____________________for cancellation of Certificate of registration with / without the
original copy of the Certificate of registration.

Place :____________________

Date : ____________________ Receiving Officer

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Form D

(see rule 19)

Purchase Register or Register of Goods

Sr
No.
Name and address of
Vendor
Local
body tax
Regn No
Commodity Purchase value of
goods/
Processing
charges
chargeable to
local body tax
Local body
tax
Payable
(1) (2) (3) (4) (5) (6)

The dealer should maintain register of purchase in accordance with following:

(1) It should be chronologically maintained
(2) Entry of goods to be made as per date of receipt in the City.
(3) Incorporate the detail of purchase/ import viz.(
a) Invoice No. and Date.
(b) Name and address of selling dealer/consignor
(c) If local R.D. the R.C No.
(d) If not local, the place from where goods moved for sale by selling dealer.
(e) Purchase price in case of Branch transfer means the value of goods.

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FORM E-I

[See Rule 29(2) (b)]

RETURN-CUM-CHALLAN
FORM OF HALF YEARLY RETURN

Period from …………….. to ………………..

1.
Local Body Tax Registration No._________________________________
2.
Name of Dealer.______________________________________________
3.
Address & Telephone No.________________________________________
4.
Calculation of Local Body Tax Payable:A.
Value of Goods received for consumption,
use or sale (inclusive of goods returned) Rs……………………
B.
Deduct.1.
Purchase from Local body tax registered dealer Rs.…………………
2. Exemption u/s 152Q (Tax free)
Rs.…………………
3. Exemption u/r 28 (goods for State/Central Govt.) Rs …………………
4. Value of goods imported for export u/r 32 Rs.…………………
5. Receipt on account of Return/rejection
within six months. Rs.…………………
5. Calculation of Local body tax payable:Commodity
imported
(Received)
Goods covered
by schedule
entry
Rate of local
body tax
applicable
Value of goods
liable for local
body tax
Amount of local
body tax
payable

6.
Information regarding Goods imported for process (u/r 28):A)
Open stock at the beginning.
Rs. ………………

B) Value of goods imported for processing on
job work during the half year Rs. ………………

C) Value of total goods for processing in premises till
end of the half year (A+B) Rs. ………………

D) Value of goods processed & exported out of
above during the half year Rs. ………………

E) Total balance left in premises at the end of this
half year (C -D) Rs. ………………

7.
Value of goods liable for Local body tax as not
exported within 6 months. Rs. ………………
8.
Less Refund u/r 32 Rs.………………
9. Total Local body tax Payable
Rs.………………

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10. Interest for delayed payment
Rs………………..
11. Amount Payable :-
Rs. ………………
12. Amount paid with this Local body tax Challan
Rs.………………
(In Words) Rs.………………………………………………
13.Amount paid by Cash/Cheque No……………..dated……….
Bank Name……………………….Branch……………………………
The above information is true to the best of my knowledge and belief.

Date :-
Signature

For Office Use

Received the amount of Rs.……………( in words) Rs……………………………………………..

Date :-Cashier/Accountant of the bank
Place :-Bank seal & date

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Challan for the Bank
Tax Collection
Challan for the Bank
Tax Collection
Name and Address Name And Address
R. C. No. R. C. No.
Period From To Period From To
Rs. Rs.
Local body tax … Local body tax …
Interest u/r … Interest u/r …
Penalty u/r … Penalty u/r …
Security Amount … Security Amount …
Fees … Fees …
_______________ ____________
Total Amount … Total Amount …
Amount paid with Return – cum – challan (in Amount paid with Return – cum –Challan (in
words)…………………………………… words)……………………………………………………
…………………………………………… ……………………………………..
(in figures)…………………………………… (in figures)……………………………………
Amount paid in cash/by Cheque No………… Amount paid in cash/by Cheque No…………
Dated……………of Bank…………………… Dated……………of Bank……………………
……………………Branch………………………….. ………………………Branch………………………..
Date : Date :
Place : Place :
Designation : Signature Designation : Signature
For Office use only For Office use only
Received Rupees (in words)……………… Received Rupees (in words)………………
……………………………………………. …………………………………………….
……………………………………………. …………………………………………….
……………………………………………. …………………………………………….
(in figures)………………………………… (in figures)…………………………………
Date of Entry: Challan No. : Date of Entry: Challan No. :

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FORM E -II

[See rule 29(2) (b)]

Form of Annual Return

Return – cum – Challan

Period from…………………….. to………………………

Local Body Tax Registration No………………………………………………

Name and address of the dealer…………………………………………………………………..

……………………………………………………………………………………………………………

………………………………………………Cell / Telephone No. ………………………………..

PART-I

1. Turnover of all sales (including value of goods
sent outside the City on consignment basis Rs____________.
2. Details of receipt of goods (by purchases,
by transfers and by return of goods/rejection) ____________
PART – II

3.Value of goods received for consumption use or sale,

in rupees.
(a) By Import _______________________
(b) By Transfer _______________________
(c) By Return of goods/rejection ________________________
4. Total Rs. _______________________
5. Deduct.Value
of goods in rupees(
a) purchased from local R.D. ______________________

(b) Received by transfer within the City ______________________
(c) Received back on account of Return/rejection
within six months. ______________________
(d) Exempt U./section 152Q ______________________
(e) Exempt under rule 28 ______________________
6. Total of (a) to (e) Rs. ________________________
7. Value of goods liable for Local body tax (4 -6) Rs. ________________________
8. Calculation of Local body tax payable on goods in part II:Commodity
imported
1
Goods
covered by
Schedule
entry
2
Rate of Local
body tax
applicable
3
Value of goods
liable for Local
body tax
4
Amount of Local
body tax
payable
5

PART –III

9. Details of goods imported for export u/r 32 :-.
(a) Opening stock of goods imported for export
as on 1st April ________. Rs__________________

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(b)
Value of goods imported for export u/r32
during the year Rs.__________________
10. Total of (a) and (b)
Rs.__________________
11. Value of goods exported within six months Rs.__________________
12. Value of goods not exported within six months
and on which Local body tax is payable Rs.__________________
13. Balance value of goods which are not exported and
in respect of which the period of six months is not over Rs.__________________
14. Refund admissible in respect of the goods exported
within six months (column 11) Rs.__________________
15. Calculation of Local body tax leviable on the value of goods shown in 12.
Commodity
imported
1
Goods
covered by
Schedule
entry
2
Rate of Local
body tax
applicable
3
Value of goods
liable for Local
body tax
4
Amount of Local
body tax
payable
5

PART – IV
Details of goods Imported for processing on job work basis under

Sub-rule (4) of rule 28.
16. (a) Value opening stock of goods imported and remained
unprocessed as on 1st April__________
(b) Value of goods imported for processing
on job work basis during the year
17. Total of (a) and (b)
Rs.___________
Rs.___________
Rs.___________
18. Value of goods processed and exported within six months.
19. (a) value of goods not processed and not exported
within six months
(b) value of goods processed but not exported
within six months
Rs.___________
Rs.___________
20. Total of 19 (a) and (b) on which Local body tax is payable Rs.___________
21. Balance value of goods which are not processed/processed
and not exported and in respect of which the period
of six months is not over Rs.___________

22. Computation of local body tax payable on goods imported but
not exported within six months as shown in Column 20:Commodity
imported
1
Goods
covered by
Schedule
entry
2
Rate of
Local body
tax
applicable
3
Value of goods liable
for Local body tax
4
Amount of Local
body tax
payable
5

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PART – V
Value of goods exported for processing out of the City and
imported duly processed [see sub-rule(3) of rule-28]

23.(a) value of opening stock of goods exported for processing

out of the City and not imported as on 1st April____________
(b) value of goods exported out of the City for processing
during the year
Rs.______________
Rs.______________
24. Total of 23 (a) and (b) . Rs. _____________
25. (a) value (excluding processing and other charges etc.) of
goods exported for processing and re-imported
after being duly processed, within six months.
(b) ) value addition i.e. processing charges, transport, and
other incidental charges etc. in respect of goods duly
processed and re-imported from out of the City
within six months
Rs._____________
Rs._____________
26. Value of goods exported for processing and not received back
within six months out of column 24. Rs._____________
27. Value of goods exported for processing and where the period of
six months is not over Rs._____________
28. Computation of Local body tax in respect of column 25 (b)Amount
in Rs.

Goods
imported
by
schedule
entry
1
Rate of
Local
body tax
applicable
2
Value of
goods
processed
and
imported
3
Local body
tax
payable
4
Corresponding
value of goods
sent for
processing
5
Local
body
tax paid
on the
value
6
Balance
to be
paid
7

PART – VI
Claim for refund of Local body tax u/r32 (exported).

29 Value of goods exported u/r32 (within six months) Rs.________________

30. Computation of refund in respect of column 29:Commodity
1
Goods
covered
by
schedule
entry
2
Rate of
Local body
tax
applicable
3
Value of
Goods
exported in
Rs.
4
Corresponding
Purchase value
on which Local
body tax paid.To
be estimated if
not available
(in Rs).
5
Local
body
tax paid
in Rs.
6
Refund
90% of
the
amount
paid
earlier
in Rs.
7

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PART – VII
Calculation of Total Local body tax payable

31. Local body tax payable as per:(
a) Item 08 Rs.___________
(b) Item 15 Rs.___________
(c) Item 22 Rs.___________
(d) Item 28 Rs.___________
32. Total Rs __________
33. Deduct(
a) Amount of refund as per Item 30 Rs.__________
(b) Amount paid vide Challan dated………… Rs.__________
34. Total Rs._________
35. Net amount of tax payable/refundable (strike out whichever is
Not applicable):(
a) Tax Rs.___________
(b) Interest Rs.___________
(c ) Penalty Rs.___________
(d) Security Deposits Rs.___________
(e) Fees Rs.___________
36. Total Rs.___________
37. Amount paid with this return cum challan
(in words ) Rs.____________
(in figures) Rs_______________________________________
38. Amount paid in cash/by Cheque No…………….
dated…………….. of Bank…………………………….Branch…………………..
Bank A/c. No…………………………………..
The above statement is true to the best of my knowledge and belief.

Date:……………………..
Place:…………………… Signature

For Office use
Received the amount of Rupees(in words )…………………(in figures)…………………………..
Date :

Place; Cashier/Accountant

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Challan for the Bank
Tax Collection
Challan for the Bank
Tax Collection
Name and Address Name And Address
R. C. No. R. C. No.
Period From To Period From To
Rs.
Local body tax …
Interest u/r …
Penalty u/r …
Security Amount …
Fees …
_______________
Total Amount …
Rs.
Local body tax …
Interest u/r …
Penalty u/r …
Security Amount …
Fees …
____________
Total Amount …
Amount paid with Return – cum – challan (in Amount paid with Return – cum –Challan (in
words)…………………………………… words)……………………………………………………
…………………………………………… ……………………………………..
(in figures)…………………………………… (in figures)……………………………………
Amount paid in cash/by Cheque No………… Amount paid in cash/by Cheque No…………
Dated……………of Bank…………………… Dated……………of Bank……………………
Branch……………………….A/c.No.………….. Branch………………………….. A/c.No.……….
Date:
Date :
Place : Place:
Designation : Signature
Designation : Signature
For Office use only
Received Rupees (in words)………………
…………………………………………….
…………………………………………….
…………………………………………….
(in figures)…………………………………
Date of Entry: Challan No. :
For Office use only
Received Rupees (in words)………………
…………………………………………….
…………………………………………….
…………………………………………….
(in figures)…………………………………
Date of Entry: Challan No. :

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16

FORM F

[See rules 18 and 29 (1)]

Intimation of Nomination/Declaration of name of manager of business

To,

I, ———————————————————————–am a registered
dealer/I,——————————————————————————-Partner/
Director/Manager/Trustee/Officer-in-Charge of *———————————————————————————(
Firm ,Company etc.) who is a registered dealer,
carrying on the business known as ———————situated at———————————————————————————————————-
and holding Certificate of
Registration No.————–dated———————hereby intimate that with effect from
———————–I /the said——————————————–( Firm, Company etc.)
have/has nominated shri/shrimati Kumari*——————————————————of

(address) whose three specimens of signature given below which Shri/Smt./Kumari*
—————————————————-intends to use for signing on my behalf/on
behalf of the said—————————————————(Firm, Company, etc.) for the
purpose of Local body tax Rules.

I have /the said—————————————-(firm/Company etc.) declared
Shri/smt/kumari *————————————————————————————–of
——————————————————————————————–(address)
to be manager of the business of the said M/s.————————————————–(
Firm, Company, etc.) for the purpose of the Local body tax rules.

Specimens of the signature of the person nominated

1.——————————————————————————————-

2.——————————————————————————————-

3.——————————————————————————————-

I hereby declare that this nomination supersedes all the previous
nominations made by me/the said—————————————————————(
firm ,company etc) in this behalf.

I—————————————————–/The said—————————-(
Firm/Company etc.) shall be responsible for carrying out all the undertakings and
fulfilling all the conditions contained in the recitals of the certificates issued and
signed above said nominee(s) in respect of for the purpose of the Local body tax
Rules.

Place :————————-Signature
Dated :——————Status

* Strike out whichever is not applicable.

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FORM G

[See rule 29(3)]

To,

Reference No. ————–

You are hereby required to furnish to me at my office at ——————————-on
or before ——————————, a return of your turnover of sales
and turnover of purchases of all goods in (Form E-I/E-II) (copy enclosed) for the
period from—————–to—————-and to furnish to me similar return for each
subsequent half year/year within fifteen days from the expiry of the relevant period.

SEAL
Place :————————-Signature
Dated :————————-Designation

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18

FORM -H

[See rule 33 (7)]

Notice

M/s. ————————————Registration No. ——————–

* Whereas, I desire to satisfy myself that the returns furnished by you in respect of
the period from ……………………… to……………………….. are correct and complete;
* Whereas being a Registered dealer, you have not furnished by the prescribed
date returns in respect of the period from……………………to………………………..
* Whereas being liable to pay tax under the Local body tax rules in respect of the
period from ………………… to ………….………, you have failed to apply for
registration under rule 33 of the said rules;
Therefore, you are hereby directed to attend at …………………………(place)
at………….on……………..and

* (1) to produce or cause to be produce any evidence on which purely in support of
the returns and at the same time to produce or cause to be produced the following
documents and account:Sales
and purchase registers, ledger, cash book, stock register, copy of trading
account, Profit & Loss A/C, Balance sheet, month wise summary statements of Sales
and Purchases, refund claims, etc. and furnish or cause to be furnished the
following information :–
…………………………………………………………………………………………………………………

* (2) to show cause as to why you should not be assessed under sub-rule (3) (i) /
(ii)/ (iii) / (iv) / (4) (i) / (ii) / (5) / (6) of Rule 33 of the said rules.
* (3) to show cause as to why a penalty under clause (a) of sub-section (1) of
section 152 L of the Bombay Provincial Municipal Corporations Act, 1949 should not
be imposed upon you ;
* You are also required to show cause as to why a penalty under sub-section (2) of
section 152 L of the Bombay Provincial Municipal Corporations Act, 1949 in respect
of the period from ………………. to …………….. should not be imposed on you.
* You are also required to show cause as to why a penalty under clause …………..
of sub-section (1) of section 152 L of the Bombay Provincial Municipal Corporations
Act, 1949 in respect of the period from …………….. to ……………. should not be
imposed on you.
SEAL

Place :

Signature
Date : Status

*Strike out whichever is not required.

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19

FORM-I

[See rule 33(9) ]

Order of Assessment

Period from…………………….. to………………………
Name and address of the dealer…………………………………………………………
…………………………………………………………………………………………………

……………………………. …………………Telephone No. ………………………………..

Registration No…………………………….

PART – I

Item As returned by As assessed
the dealer

1. Total of Consignment transfers out of City
and gross Turnover of sales value in Rs. ___________ _____________
2. Total Value in rupees of Goods received
on Consignment transfer and Turnover of
Purchase (Shown in Item 3 below) in Rs. __________ ___________
PART – II

3. Details of receipt of goods:Value
of goods received for consumption
use or sale in rupees
(a) By Purchase _____________ __________
(b) By Transfer _____________ __________
(c) By Return of goods / rejection _____________ __________
4 Total _____________ ___________

5. Deduct.Value
of goods in rupees –
(a) Purchased from Local R. D. ________ _________
(b) Received by Transfer within the City ___________ ____________
(c) Received on account of Return / rejection
within six months
___________ ____________
(d) Exempt U./Section 152Q __________ ____________
(e) Exempt under rule 28 (1),(2)
belonging to Government ___________ ___________
6. Total ___________ ____________
7. Value of goods liable for local
body tax (4-6) __________ ____________

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8. Calculation of local body tax payable on good in part II
As returned by the dealer

Commodity Schedule Entry Rate of Local
Body Tax
Value of goods
liable for local
Body Tax
Rs.
Amount of local
body tax payable
Rs.
(A) (B) (C) (D) (E)

Total

As assessed

Commodity Schedule Entry Rate of Local
Body Tax
Value of goods
liable for local
Body Tax
Rs.
Amount of local
body tax payable
Rs.
(A) (B) (C) (D) (E)

Total

PART-III
9. Details of goods imported for export U/R 32:Item
As returned
by dealer
As assessed
(a) Value of goods received for export and
not exported upto the end of year. Rs. _________
(b) Value of goods imported for export
during the year Rs. _________
___________
___________
10. Total – Value of goods for export U/R 32
11. Deduct-
Value of goods exported U/R 28 and
and exempted U/S 152Q
12. Value of goods liable for Local body tax
Rs. ________
Rs._________
Rs._________
_________
_________
____________

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21

13. Computation of local body tax payable:As
returned

Commodity Schedule Entry Rate of Local
Body Tax
Value of goods
liable for local
Body Tax
Rs.
Amount of local
body tax payable
Rs.
(A) (B) (C) (D) (E)

Total

As assessed

Commodity Schedule Entry Rate of Local
Body Tax
Value of goods
liable for local
Body Tax
Rs.
Amount of local
body tax payable
Rs.
(A) (B) (C) (D) (E)

Total

PART-IV
Details of goods imported for processing on job work basis under
Sub-rule (4) of rule 28

Item As returned As assessed
by dealer

14. (a) Value of goods imported and
remained unprocessed upto the end
of last year. Rs.__________ ______________
(b) Value of goods imported for
processing on Job work basis
during the year Rs.___________ _______________
15. Total Value Rs____________ ______________
16. Value of goods processed and
exported out of above during the
year within six months Rs.____________ _____________
17. Value of balance goods not exported Rs.____________ ____________

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18. Value of goods liable for local body tax
as not exported within six months Rs.__________ ____________
19. Value of goods not liable for local body tax
carried forward to next year Rs._________ ____________
20. Computation of local body tax payable on goods imported but not exported within
six months column 18
As returned

Goods Covered Rate of local body Value of goods liable Amount of local body
by schedule entry tax applicable for local body tax tax payable
Rs. Rs.
(A) (B) (C) (D)

Total

As assessed

Goods Covered Rate of local body Value of goods liable Amount of local body
by schedule entry tax applicable for local body tax tax payable
Rs. Rs.
(A) (B) (C) (D)

Total

PART V

Details of goods exported for processing out of the City and imported duly
Processed [See sub rule (3) of rule 28]

Item As returned As assessed
by dealer

21.(a) Value of goods exported for processing
and not imported upto the end of last year Rs. _________ ____________

(b) Value of goods exported for processing
during the year Rs __________ ___________
22.Total Rs. _________ ___________

23. Value of goods imported duly processed
out of above ( inclusive of processing,
spares, transport and incidental charges, etc)
within six months Rs. __________ ____________

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23

24. Total value of goods sent for processing
and remaining out of the city up to end
of this year Rs._________ __________
25. Value of goods sent for processing not
received back within six months out
of item 24 Rs. _________ ___________

26. Value of goods sent for processing and
where the period of six month is not
over pending for import at the end
of the year (24-25) Rs.__________ ___________

27. Computation of local body tax
As returned

Amount in Rs.

Goods imported Rate of Value of goods Local body Corresponding local body Balance
Covered by Local processed and tax payable value of goods tax paid payable
Schedule entry body Tax imported sent for on the value (4-6)
applicable processing
(1) (2) (3) (4) (5) (6) (7)

Total Rs….

As assessed

Goods imported Rate of Value of goods Local body Corresponding local body Balance
Covered by Local processed and tax payable value of goods tax paid payable
Schedule entry body Tax imported sent for on the value (4-6)
applicable Rs. Rs. processing
Rs. Rs. Rs.
(1) (2) (3) (4) (5) (6) (7)

Total Rs….

PART VI
Claim for refund U/R 32(exported)

28. Value of goods exported U/R 32 (within six months) during the year
(a) As returned by dealer Rs.________(b) As assessed Rs.__________
29. Computation of refund As
returned

Commodity Goods covered Rate of Local Value of goods Corresponding purchase Local body Refund 90%
By Schedule body tax exported value on which Local. tax paid. the amount
entry applicable (in Rs) body tax paid. (in Rs) paid earlier

To be estimated if (in Rs.)
not available
(in Rs) .

(1) (2) (3) (4) (5) (6) (7)
Total Rs.

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As assessed

Commodity Goods covered
By Schedule
entry
Rate of Local Value of goods Corresponding purchase Local body Refund 90%
body tax exported value on which Local. tax paid. the amount
applicable (in Rs) body tax paid. (in Rs) paid earlier
To be estimated if (in Rs.)
not available
(in Rs) .
(1) (2) (3) (4) (5) (6) (7)

Total Rs.

PART VII
Calculation of Total Local body tax payable.

Item As returned As assessed

30. Local body tax Payable as per :
(a)Item08 …Rs.…
(b)Item13 …Rs.…
(c)Item20 …Rs.…
(d)Item27 …Rs.…
31. Total – Rs.
32. Deduct –
(a) Refund claimed/allowed
(b) Amount paid by separate
Challan, No…………..dated………….
33. Total – Rs.
34. Net amount of Local body tax. payable –
Details –
(1)
(2)
(3)
(4)
(5)
(6)
35. Details of Payment made by dealer with return Period
Challan No. Date Amount Rs.

Total…

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36. Total Local body tax and Penalty due/refund, if any Rs……………………..
37. Assessment order.
SEAL
Place : _________________ Signature
Dated : _________________ Designation

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26

Form “J”
[See rule 33 (11)]
Notice of Demand

To,
………………………………………………….

………………………………………………….

……………………………………………………..

R. C.No. ……………………………………….
Take notice that the Local body tax payable by you for the period
from………….to……………has been determined by me under Order No …………….
dated …………….at Rs ………………. A penalty/Interest of Rs…………………. has
also been imposed under rule 48.

2. The total amount of Rs…………………. should be paid to Corporation at on or
before…………..
3. If you do not pay the amount by the date specified above, the amount will be
recoverable as an arrears of Property Tax under rule 40 of Local body tax Rules.
4.If the amount is not paid without reasonable cause by the specified date, you will
also be liable to penalty under rule 49 of the Local body tax rules.
5. Any appeal against the order must be presented to the authority prescribed within
the time and the manner laid down in section 406 of the Bombay Provincial Municipal
Corporations Act, 1949.
SEAL
Place: …………… Signature
Dated …………….. Designation

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27

FORM K
[ See rule 34( 1 ) ]
Notice regarding assessment/re-assessment of Local body tax

To,
…………………………..
…………………………..
…………………………..
………………………..
Registration No………….

Whereas, I have reason to believe that your turnover in respect of the
following sales and purchases, namely:

………………………………………………………………………………………………………………..
………………………………………………………………………………………………………………………
in respect of the period from ……………………………….to …………………………….

has *escaped assessment/been under assessed/been assessed at a lower rate

And
deduction of the following sales and purchases, namely:…………………………………………………………………………………………………
………………………………………………………………………………………………….
have been wrongly made from your turnover in respect of the period
from…………to……………,

Now, therefore, you are hereby directed to attend at……………………
(place) at ……………………(time) on……………………..(date)……………………….
and to show cause as to why the amount of Local body tax payable by you in respect
of the said sales and purchases for the said period should not be *assessed/reassessed
and to produce or cause to be produced the following documents and
accounts:
…………………………………………………………………………………………………
…………………………………………………………………………………………….and
to furnish or cause to be furnished the following information :…………………………………………………………………………………………………
…………………………………………………………………………………………………
…………………………………………………………………………

You may also produce or cause to be produced any other evidence for
determining the correct, amount of Local body tax payable by you for the said period.

SEAL
Place:……………… Signature
Dated:…………… Designation

*Strike out whichever is not required

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28

FORM L

[See rule 40(3)]

Notice for payment of Local body tax, penalty, interest, sum forfeited or fine

To

……………………………………

…………………………………

……………………………….

Registration No. …………………..

Whereas, the return under rule 29(1) of the Local body tax Rules, for the
period form ………….. to ……………………………… has been furnished by you :but
the amount of Local body tax, viz. Rs. ………… (and the amount of penalty viz.
Rs. ……) which is due according to the return has not been paid as required under
rule 40 of the Local body tax Rules.

*but the copy of the challan accompanying the return shows payment of only Rs.
…………. as against the amount of Local body tax of Rs. ………….. (and the amount
of penalty of Rs. ………) which is due according to the return and required to paid
under rule 40 of the Local body tax Rules.

Therefore, you are hereby directed to pay the sum of Rs…….. (in words Rupees
…………………….) to the corporation on or before…………… (date) and to produce
the receipted copy of the challan in proof of payment before me on a date not later
than the …………… day of ………………………. failing which the said sum of
Rs……… will be recoverable from you as an arrears of property fax.

2. You are hereby informed that if you fail so to pay the amount of Local body
tax aforesaid without any reasonable cause you would be liable for action under
section 152-L of the Bombay Provincial Municipal Corporations Act, 1949
SEAL
Place : …………………… Signature ……………………………………
Dated : ………………… Designation …………………………………

*Strike out whichever is not necessary.

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29

Form M
[See rules 32 and 44]

Refund Payment Order

Book No ………. Voucher No ………… Book No ……… Voucher No ………

REFUNDS
Counterfoil Order for the refund of Local body
tax under the Local body tax Rules

Refund payable to……………………..

Registration certificate No ……………

Date of order directing refund…………

Amount of refund Rs………………….

Number in Collection Register showing
the collection of amount regarding
which amount is made…………………

(singed)…………………………………

Designation……………………………..

Dated…………………………………….

Signature of the recipient of the voucher

Date of Encashment…………………….

REFUNDS
Order for the refund of Local body tax
under Local body tax Rules

To

The Officer,
.……………………
………………….

1.
Certified that with reference to the
assessment record of …………………………bearing
Registration Certificate Number…………
for the period from ..………… to ….. ………

a refund of Rs…………… is due to…………..
………………………………………

2.
Certified that the amount of tax concerning
which this refund is allowed has been duly
Credited to the Corporation account.
3.
Certified that no refund order regarding the
sum now in question has previously been
granted and this order of refund has been
entered in the original file of assessment
under my signature.

4.
Please pay to …………………
the sum of Rs. …………………… (in figures)
………….………………………(in words)

Dated ……………………………..

(Signed) ……………………………

Designation ………………………

Date of Encashment ………………
Date : ……….. Place ……………
Pay Rupees ……………………only.
The day of………………………….

Officer

Received Payment

Claimant’s Signature

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30

FORM N
( See Rule 47 )

Notice

To,

______________________.

Registration No…………………..

You are required under sub-section (1) of section 152-J of the BPMC Act, 1949
to produce or cause to be produced before me at (place)…………………
………………..(date)……………..at(time)………………., the following documents &
accounts :––

………………………………………………………………………………………………
…………………………………………………………………………………………………
…………………………………………………………………………………………………
…………………………………………………

And * to furnish me the following information
…………………………………………………………………………………………………
…………………………………………………………………………………………………
……………………………………………………………………….

Please note that, if you do not comply with requirements of the notice you shall
render yourself liable to prosecution for an offence under clause (m) of sub-section

(I) of section 152-L of said Act, which is punishable with imprisonments for a term,
which may extend to two years and with fine and when the offence is continuing one
with a daily fine not less than rupees one hundred during the period of continuance
of the offence.
SEAL
Place : ……………………… Signature

Date …………………………. Designation

*Strike out whichever is not required.

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31

FORM O
[See rule 49(2)]

Notice for forfeiture and for imposing penalty
To

…………………………………..

…………………………………

………………………………..

Registration No. ………………..

Whereas, I have reason to believe that during the period from
…………………..to ……………………

*(a)*(i) You have collected by way of Local body tax a sum of Rs. …………. in
respect of sales of goods on which by virtue of section 152Q of BPMC Act, 1949 no
Local body tax is payable.

*(ii) You have collected on your sales of goods a sum of Rs. …………..by way of
Local body tax from other persons in excess of the tax payable by you.

OR

*(iii) You have collected local body tax in respect of schedule B goods on which
no local body tax is leviable under the provisions of the Rules.

*(b)(i) being a dealer liable to pay Local body tax under the BPMC Act, 1949
and Local body tax Rules.

*(ii) being a dealer who was required to do so by notice served on you by
Commissioner, you have failed to keep a true account of the value of goods
purchased or sold by you.

*(c) you have failed, even though directed so to do under section 152-I of the
BPMC Act, 1949, to keep any accounts and records in accordance with such
directions,

Therefore, you are hereby directed to attend at ………………………… (place)
at ……………………. (Time) on ………………………..(date) and to show cause why,

*(1) sum of Rs. …………… or such other sum as may be finally determined as
collected wrongly by you by way of Local body tax should not be forfeited, and/or

*(2) a penalty under section 152L of the BPMC Act, 1949 should not be
imposed on you.

SEAL
Place :……………………… Signature
Date: ……………………… Designation

*Strike out whichever is not required.

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32

FORM -P

(See rule 35(1))

Notice of Rectification of Mistake

To,

…………………………

……………………..

………………………

Registration Certificate No………………..

Whereas, it appears that the order/decision No………………..dated
…………passed/given by…………………..………………………………for the period
from………………..to……………………in your case, there is the following mistake
namely :–
…………………………………………………………………………………………………
……………………………………………………………………………………………….

And whereas, it is proposed to rectify the mistake as stated below which will
have the effect of enhancing, the Local body tax/ reducing the amount of refund,

Therefore, you are hereby given notice under the proviso to sub–rule (1) read
with sub-rule (2) of rule 35 of the Local body tax rules, that if you wish to prefer any
objection against the proposed rectification you should attend at the office of the
undersigned at on ………………. the day of………………

List of the rectification proposed to be made:–
…………………………………………………………………………………………………
…………………………………………………………………………………………………
………………………………………………………………………………………………..

SEAL
Place : …………………… Signature
Dated : …………………… Designation

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33

FORM “Q”
[ See rule 54 (1) ]

Authorization for appearance before authority in proceeding

I,—————————————————————————————-am a
registered dealer/I,——————————————————————————-Partner/
Director/Manager/Trustee/Officer-in-Charge of *———————————————————————————(
Firm ,Company etc.) who is a registered dealer,
and holding Certificate of Registration No.——————dated———————,

Hereby appoint Shri…………………………………………………………

* who is my relative
*
a person regularly employed by me/ the ……………………………………..(Firm,
Company etc.)
* a Legal Practitioner
* a Chartered Accountant
* a local body tax Practitioner
to attend on my behalf / behalf of the ……………………………………(Firm,
Company etc.) before ………………………………………………(State the Authority)
in the proceedings…………………………………………(describe the proceedings)
and to produce accounts and documents and to receive on my behalf / behalf of the
………………………………………………….(Firm, Company etc.) any notice or
document issued in connection with the said proceedings and to take all necessary
steps in the said proceedings. The said Shri ……………………………………… is
also hereby authorized to act on my behalf / behalf of the ………………………(Firm,
Company etc.) as per the said proceeding.

I/The ……………………………………………..(Firm, Company etc.) agree to ratify
all acts done by the said Shri………………………………………………………………
in pursuance of said proceeding.

Place : ………………
Signature

Dated : ………………
Designation

*strike out which is not applicable

ACCEPTANCE

I, ………………………………………………………………do hereby state that I am

* a relative of ……………………………………………………………………………………
* a person regularly employed by ………………………………………………………………
* a legal practitioner
* a Chartered Accountant
* a local body tax Practitioner duly enrolled with Corporation and my enrolment No. is
……………….…..……..…and that I accept the aforesaid appointment.
Place :………………
Signature

Dated :………………

*strike out which is not applicable

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34

Form R

( see rule 27)

Declaration for permission to pay lump sum amount of local body tax
under rule 27 of the Bombay Provincial Municipal Corporations (local body
tax) Rules, 2010.

To,
The Municipal Commissioner.
………………………………..
………………………………..

1. Whereas, I……………………………………….(state here the name of the
person signing the application) the …………………………..(state here the status
of the person signing the application) am carrying on business of
…………………………………………………..(state here the nature of business)
in the name and style of ………………………………………………(state here the
name of the firm, company etc.) at ………………………………………….
………………………………………………………………………………………….
(state here the address of the firm, company etc.)and holding a certificate of
local body tax registration bearing No………………do, hereby, declare that the
turnover of all our sales or the turnover of all our purchases during the
immediately preceding financial year was in the range shown at slab No …….of
the table below and is not likely to exceed the range of the said slab during the
current financial year ………….

I, therefore, hereby request for permission to pay a lump sum amount of local
body tax of Rs……….. for the period from……….. to………….

Slab
No.
Turnover of all purchases during
a year
Local body tax payable
per year Rs.
1 Up to Rs. 1,00,000/Nil
2
Exceeding Rs. 1,00,000/-but not exceeding Rs.
2,00,000/2,000
3
Exceeding Rs. 2,00,000/-but not exceeding Rs.
3,00,000/3,000
4
Exceeding Rs. 3,00,000/-but not exceeding Rs.
4,00,000/4,000
5
Exceeding Rs. 4,00,000/but
not exceeding
Rs.5,00,000/5,000/

2. Further, if the turnover of all my purchases exceeds the limit of the declared
slab for which the permission to pay lump sum amount of local body tax shall be
given to me in pursuance of this application, I hereby, undertake to inform the
Commissioner within thirty days of such turnover exceeding the said limit. I
further undertake to pay the amount of local body tax payable in accordance with
sub rule (2) of rule 27 of these rules.
3. I am aware of the fact that under the provisions of sub-rule (5) of rule 48 of
the local body tax rules, the furnishing of a false declaration entails the payment
by way of penalty, of a sum not exceeding five times the amount of local body tax
which, in the opinion of the Commissioner, would have been leviable.
4. The statements contained in the above declaration are true to my knowledge
and belief.
Date………………………….. Signature
Place…………………………. Status.

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35

FORM S

[See rule 36 (1) (a)]

Appeal under Section 406 (6)(i)(ii) of the Bombay Provincial Municipal
Corporation Act, 1949 against demand notice raised under
rule 33/34 of the Bombay Provincial Municipal
Corporation (Local body tax on entry
of the Goods) Rules 2010.

To,
……………………………….
……………………………….

Date of Demand notice against which the appeal is made …………
Date of receipt of the demand notice ………………………..
Name and designation of the officer who issued the demand notice …………………
Period of assessment/Reassessment : from……………to………………

The appeal petition of Shri/Smt ………………………………………….. who is
a Proprietor/Partner/Director/Authorized Person/Manager/ …………………… of M/s
……………………………………… carrying on the business known as
M/s……………………………… holding registration Certificate No. ……………
dated ……………. under the Rule 10(1) of the Bombay Provincial Municipal
Corporation (Local body tax ) Rules, 2010 whose only/main place of business
at………………………………………………………………………………………………
……………………………………………………………………………………………….

2. During the period from ……………….to……………….. the appellant has been
assessed/re-assessed under rule 33/34 of the Bombay Provincial Municipal
Corporation (Local body tax) Rules, 2010 to local body tax amount as shown in
column 2 of the table below but the appellant’s turnover of purchases liable to local
body tax is as shown in column 3 of the following table:Particulars
of local body tax
leviable and/or penalty /
interest levied.
Turnover of purchase liable to local body tax and
local body tax levied, interest / penalty imposed
Amount
in
Dispute
(As assessed) (As Admitted by the
Appellant)
Rs.
(1) (2) (3) (4)
1. Turnover liable to local
body tax
2. local body tax Amount
3. Interest u/r
i) 48(2)(a)
ii) 48(2)(b)
4. Penalty u/r
i) 48(1)
ii) 48(2)(a)
iii) 48(2)(b)
iv) 48(2)(c)
Total Amount Rs.

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36

The turnover of purchases shown in column 3 of the above table was the
whole turnover of the appellant during the period. The appellant had no other
turnover subject to local body tax.

3. The notice of demand is attached hereto.
4. A certified copy of the order of assessment/reassessment is attached.
5. The appellant has paid the local body tax assessed including penalty,
interest as shown below-
Paid before assessment Rs……………………………..
Paid after assessment Rs……………………………..
Paid in appeal Rs……………………………..
Balance due Rs……………………………..

Chalan No. Date Amount

6. Grounds of appeal relied on :……………………………………………………
7. The appellant therefore prays That
he may be assessed accordingly or that he may be declared not to be
chargeable under the said Rules or that he assessment may be cancelled and/or
remanded to …………………for reassessment or…………………….the order (s)
imposing penalty/charging interest may be set aside.

8. The appellant M/s……………………………..does hereby declare that what is
stated herein is true to the best of his knowledge & belief.
Signature
Place :

Date : ………….

By Order and in the name of the Governor
of Maharashtra.

A.S. Jiwane
Deputy Secretary to Government.