8/13/2019 Description of goods/Dealer and Conditions for Exemption/Concession

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Description of goods/Dealer and Conditions for

Exemption/Concession

Notification No. date and date of

effect

Sales of any goods made by any such dealer to a registered dealer

for the purpose of setting up,operation,maintenance,maintenance,manufacture,Trading,production,processing,assembling,repairing,reconditioning

,re-engineering ,packaging or for use as packing material orpacking accessories in a unit located in Madras Special Economic

Zone,Tambaram,Chennai and other Special Economic Zone in thestate of Tamil Nadu notified by the Government of India or fordevelopment operation and maintenance of Special Economic

Zone by the developer of the Special Economic Zone,If suchregistered dealer has been authorized to establish such unit or such

other establishments within the Special Economic Zone, or to bedevelop, operate and maintain such Special Economic Zone by theauthority specified by the Central Government,subject toi)The dealer obtaining and furnishing a certificate in the formappended below and ii)the goods purchased being used only for

the aforesaid purpose

G.O.Ms.No.75 dated the 28thJune

2005,Which was replaced byNotification No-II (1)/CTR/58(A-14)/2006,Dated the 30th December

2006.

To(Name and address of the purchasing dealer)..

..

TNGST NOCST NO .

(Name and address of the selling dealer).

...

TNGST NOCST NO ..

I) Certified that the goods listed below were purchased by us for the purpose of setting upoperation,maintenance,maintenance,manufacture,Trading,production,processing,assembling,repairing,

reconditioning,re-engineering ,packaging or for use as packing material or packing accessories in our unit,located /in Special Economic Zone

for export out of india

II) Certified that we authorized to develop ,operate and maintain Special Economic Zone by theauthority specified by the Central Government .

For this purpose, the goods listed below were purchased during the year from 1-4-20 to 31-03-20

8/13/2019 Description of goods/Dealer and Conditions for Exemption/Concession

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Sl. No. Invoice No./date Description of goods Quantity Value(Rs.)

(1) (2) (3) (4) (5)

Total

(Rupees ..Only)

Place : (Signature)

Date : Name :

Status :Seal of Office: