PROFESSIONAL TAX FORM-II

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;                                                                                                                                                                                                    3 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     :                                                                               Application No:                                   

 Address:                                                                                Dated:

Signature of Receiving Officer.