FORM III
(See Rule 27)
Application for Permission to pay Tax under Sub-Section (1) of Section 5 in
ieu of Tax payable under Section 4 under the Andhra Pradesh Entertainments
 Tax Act, 1939.

 

To

The Entertainments Tax Officer,

_________________________________

_________________________________

_________________________________


Sir,

I, Proprietor of__________________________________________________(place of entertainment) situated in_____________________________________________________________________taluk _____________________________________ whose particulars are furnished below hereby signify my intention to opt for the payment of a fixed amount of tax payable under sub-section (1) of section 5 in respect of the shows to be held in the said theatre. I hereby apply for permission to pay tax under the above mentioned section and agree to abide by the rules and conditions prescribed in this behalf.

(1) Name of the proprietor and his residential address:

_____________________________________________________________________________

_____________________________________________________________________________

_____________________________________________________________________________


(2) Name(s) and address(es) of the proprietors, partners, members, all persons having any interest in
      the entertainment.                   

1

 

 

2

 

3

 

4

 

5

 


(3) Name and address of the place of                         :  
      entertainment.

  

(4) Local authority in whose jurisdiction  
      the Theatre is situated                                 :

 

(5) Classification of the theatre (whether             :  
      temporary, touring, semi-permanent,  
      Air cooled or Air conditioned)

 

(6) (a) Particulars of the Licence for cinematography exhibition granted by the licensing authority 
       under the A.P. Cinemas (Regulation) Act, 1955. (copy of licence in Form B to be enclosed)

   
     (b) Period for which the above licence is valid.

 

(7) Capacity of the place of entertainment.

Category of Class

Rate of admission

No. of seats.

Gross Collection

    (1)

(2)

(3)

(4)

  
   (a)

   (b)

   (c)

   (d)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Total Gross collection capacity per show

 

      (Rupees in words) _______________________________________________________________

 

(8)    The amount of Tax payable every              :  
week with reference to the gross  
collection capacity worked out in  
column 7 above read with section  
5(1) of the Andhra Pradesh  
Entertainments Tax Act.                           

 

(9) Date from which the applicant opts to 
      pay the amount of tax under section 5

 

I agree to furnish the security demanded for the proper payment of amount of entertainment tax due 
from me and to furnish true and correct returns of the payments for admission to the entertainments 
under each class of ticket value and in such form and at such time as may be stipulated:

 

I agree to pay the amount of entertainment tax every week as determined by you irrespective of whether 
the number of shows actually held and shall submit the returns as per the provisions of Act and Rules and 
due shall also pay any excess found within 7 days after it is demanded.

I agree and shall abide by all the conditions of the permit.  

If I fail to pay the amount of tax it is open to the Entertainment Tax Officer to forfeit the security furnished and 
recover the taxes due from me in addition.

 

Signature of Proprietor.



DECLARATION

I._______________________________________________________________ son/daughter/wife of
_____________________________________________________________________hereby declare that to the best of my
knowledge and belief the information in this application given above is true and correct.

Place    :

Date     :                                                                                               Signature of Proprietor.