FORM ST-3B

---

(see rule 7A)

Return of service tax credited to the Government of India for the period commencing on and from the 16th day of July, 1997 to the 16th day of October, 1998, in case of service provided by goods transport operator and; clearing and forwarding agents

---

Commissionerate

1. Name of the assessee

2. Category of service : Goods transport operator service/clearing and forwarding agents service

3. Service tax registration No.    (optional)

4. PAN no           (in case assessee does not have registration No.)

5. Period*

6. Value of taxable service

7. Amount of service tax payable

8. Amount of interest, if any payable

9. Mode of payment :

Challan Nos

Date of challans

* for goods transport operator service, the relevant period is from 16.11.1997 to 2.6.1998; and

for clearing and forwarding agents, the relevant period is from 16.7.1997 to 16.10.1998

Self Assessment Memorandum

1. I/we declare that the above particulars are in accordance with the records and books maintained by us and are correctly stated.

2. I/we have assessed and paid the service tax correctly in terms of the provisions of the Act and rules made thereunder.

3. I/we have paid duty within the time specified in these rules and in case of delay, I/we have deposited the interest leviable as per section 75 of the Act.

Place: Date:

Name and signature of the assessee or his authorized representatives

Acknowledgement:

Date of receipt: Place: Date:

Signature and Official Seal of the Superintendent of Central Excise

(FORM ST-3B has been inserted vide Ntf. No. 04/2003-ST, dt. 14/05/2003)

Presented by eximkey.com