FORM 409
(See rule 50)
Declaration by a registered Contractor for the purpose of clause (g) of sub section (4) of section 45
of the Maharashtra Value Added Tax Act, 2003
Serial Number
I / We, the undersigned, do hereby certify that I / the said__________________________ am / is a registered dealer
under the Maharashtra Value Added Tax Act, 2002. The details are as under
1 Name of the dealer
2 R.C. No. under M.V.A.T. Act, 2002
3 Address of the place of business
4 Name of the dealer who whom the works contract has
been assigned
5 R.C. No. under M.V.A.T. Act, 2002
6 Address of the place of business of above dealer
I / We, hereby undertake that the tax payable, if any, in relation to the turnover of sales of such works contract or
lumpsum by way of composition payable under section 42, as the case may be, shall be paid by me/the said *
________________________________
I /We, further certify that the said registration certificate was in force on the date of execution of the aforesaid
contract
Place
Signature
Date
Status
*State here the name of Firm, Company Local authority, Corporation, Society, Club, associations of persons,
Hindu undivided family, Trust, Government Department, as the case may be.
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