FORM VI
Weekly Return to be filed by the Proprietor
(See Rules 15 and 27)

To

The Entertainments Tax Officer,

______________________________

______________________________

_______________________________  

I___________________________________________________________________________son of ____________________________________________________________________on behalf of the proprietor/licensee of_________________________________________________________ situated in ________________________________________________________________________Taluk of __________________________ District of ________________________________________ furnish herewith the following particulars and the extract of the register in Form V for the week ending _____________________and enclose a crossed cheque/Demand draft/Treasury receipt bearing No. __________________ Date ______________ for an amount of Rs.________________ towards the payment of the tax due for the week ending ______________________________________.



1. Statement of Gross Collection capacity per show.

Category of class

Maximum rate of admission

Maximum number of seats permitted  

Gross                         collection  capacity

 

(1)

(2)

(3)

(4)

 

1.

 

 

 

(A)Gross Collection capacity per show.

2.

 

 

 

(B) Rate of tax on % gross collection capacity per show.

3.

 

 

 

(C) Amount of tax Rs. per show. (sec.4)

4.

 

 

 

(D) Multiplication No. factor under section 5.

5.

 

 

 

(E) Amount of tax Rs. per week (section 5)

Total gross collection capacity per show

Note :       In case of payment of tax under section 4 columns D and E need not be filled and in case of payment of tax under section 5 column C need not be filled.

 

 

2.      Statement showing number, details and particulars of shows held  during the week.

Date

Show number and name of the picture exhibited

Date


Show number and name of the picture exhibited

(1)

(2)

(3)

(4)

   

I

II

III

IV

 

 

 

 

I

II

III

IV

   

I

II

III

IV

 

I

II

III

IV

 

I

II

III

IV

 

I

II

III

IV

 

I

II

III

IV

 

I

II

III

IV

3.   Statement showing the Entertainments Tax and show tax due for the week ending.

(a)  Number of shows held during the week.      :

(b)   Amount of tax per show  
        (as per statement).              :

(c)  Amount of Entertainments tax due for   :  
      the week. (Col. (a) X (b))

(d)  Rate of tax on show (Sec. 4-A).        :

(e)  Amount of show tax due for the week.       :  
       (Col. (a) x (d))

 (f)  Total tax due. (Col. (c) + (e))            :

 (g)  Amount paid.                                   :


Challan No./ Cheque No./D.D. No. date.  
(In case of cheque/D.D. mention the name of the Bank).

Enclosure :       (i) Extract of Register in Form V.  
                             (ii) Challan/Cheque/D.D.



DECLARATION : 

I _________________________________________________________ declare that to the best of my knowledge and belief the information furnished above is true, correct and complete.


Signature _________________________ Status and relation to the Proprietor.______________________________________