FORM  II

Application for Certificate of Enrolment/Revision of Certificate of Enrolment
under the Andhra Pradesh Tax on Professions, Trades, Callings and
Employments Act, 1987
(See Rules 4(1) and 6(2))

To

The Professional Tax Officer,
_____________________________
_____________________________
_____________________________

I hereby apply for a certificate of enrolment / revision of certificate of enrolment under the above mentioned Act as per particulars given below:

1.       Name of the applicant                 :

2.       Full Postal Address                              :

3.       Date of birth and Age                  :

4.     Profession, Trade or Calling                    :

5.     Period of standing in profession
in years and months                               :

6.       Numbers of other places of works            :

      (Please give the address of the places)

7.       Annual turnover of all sales / purchases      :

*8.  Number of workers engaged in the factory      :

*9.  Number of employees in the establishment   :

*10. If Co-operative Society whether State Level :

       District Level or Mandal Level

*11.  Number of Vehicles for which permit under   

        M.V. Act is held                                         :

                     2 Wheelers                                   :         

                     Trucks and                                   :          

                     Buses                                             :

                     Total                                               :          

*12.  Enrolment No. of previous certificate,
         if any                                                                :

*13   If registered under APGST Act 1957/
        CST Act, 1956 the No. of registration
        Certificates held                                                  :

             APGST Act, 1957                                              :
             CST Act, 1956                                                   :

*14. Grounds on which revision is sought              :
       (attach additional sheets if necessary)

 
The above statements are true to the best of my knowledge and belief.

 Dated :                                                                                                                                       Signature with status.


*Please fill up whichever is applicable.

For office Use Only

Enrolment  No.                                                  :

Date of Enrolment                                             :

 
                                                                                                                                                                  Signature of Issuing Officer

Acknowledgement
(Particulars of name and address to be filled by applicant)
 

Received an application for enrolment in Form

 From

 Name    :                                                                      

 Address:                                                                    Application No:

                                                                                      Dated          :
                                                   
   
                                                                                                                                                                  Signature of Receiving Officer,