FORM No. 27B

DECLARATION

See Rule 35(13)(c)

To

The Officer in charge of. the Check Post or Barrier/

The Assessing Authority

............................................

1. (a) Name and complete address of the consignor

(b) If consignor is a dealer in KERALA his registration Certificate No. under the K.G.S.T. Act, 1963;

2. (a) Name and complete address of the consignee;

(b) If consignee is a dealer in KERALA his Registration Certificate No. under the K.G.S.T. Act, 1963;

3. Place from which goods despatched;

4. Destination (including district);

5. Brief description of goods;

6. Total quantity;

7. Total weight;

8. Total value;

9. Consignors invoice/delivery note No. & date;

10. (a) Name and full address of the carrier (Transport Co. or owner of the vehicle etc);

(b) Details of the vehicle with its number, if any;

(c) Name and address of the person (if any) in charge of the goods;

I,......................................................... declare that to the best of my knowledge and belief the above statements are true and correct.

Place:

Date:

Signature of the Consigner of the goods.

(To be completed in the office of the Check Post.)

1. Time of arrival of the vehicle at the Check Post.  

2. Time of departure of the Vehicle from the Check Post.  

3. Reasons for abnormal detention of the vehicle at the Check Post.

Place:

Date:                                                        (Seal)                           (Designation)