FORM B-1 4(See rules 15, 17-H)

Take notice that on the basis of the return in 5[Form-A1 / Form A-7] furnished by you for the year ending                 19
you are liable   under the Andhra Pradesh General Sales Tax Act, 1957 (Andhra Pradesh Act VI of 1957), to pay
a 3(tax) of Rs.                     (Rupees (in words)    only) for the year and that after deducting the total amount of the monthly
payments made by you towards the  of   3(tax) for the year , in response to the notice of provisional assessment and demand notice No. dated                                      and the further  3(tax) paid along with the return you have still to a  (further) sum of Rs.                            (Rupees(in words)           
                only).  This amount shall be paid (within thirty/    days) from the date of  this notice--
by 7(cheque) 2(demand draft) in favour of the undersigned) or
 9(by cash to the undersigned or)
by remittance into  the Government Treasury at                                                                         8(**) failing which the amount will be recovered as if it were an arrear of land revenue and you will also be laible to interest as provided in section 16 of the Andhra Pradesh General Sales Tax Act, 1957.

The above demand is only provisional and any further amount to be paid by you or any refund to be made to you will be
communicated after final assessment.

6[Turnover and total tax payable as determined by the assessing authority in respect of:-
Commodity            Description            Rate of             8Gross            Exempted             Net            10Tax
code                        of goods                 tax                turnover            turnover          turnover
                                                                                      (a)                    (b)                (a)-(b)
    1                               2                          3                    4                       5                      6                7

Date:                                                                                                                                Assessing Authority

Note:-    1.    If payment is made by cheque, [demand draft] the cheque [demand draft] shall be crossed and shall
                     be as such as under the Andhra Pradesh Treasury Code, may be received by the Treasury concerned.
              2.    Omitted by G.O.688 Rev.dt.11.10.1988

Note:-    1.    Where the assessing authority has for reasons recorded in the assessment order, proposed that the 
                      dealer should pay the (tax and surcharge on such tax) assessed within a period of less than 30 days,
                      he should strike out the figure 30 and note such lesser period specified in the order, and duly attest
                      the entry.]
Note:-    1.    This Form was amended by G.O.Ms.No.2307 Rev.dt.12.12.1957, G.O.Ms.No.1857, Rev.dt.28.10.1963,
                     G.O.Ms.No.1488 Rev.dt.20.12.1996,and G.O.Ms.626 Rev.dt.1.7.1969.
              2.    The words "demand draft" were inserted by G.O.Ms.No.1251 Rev.dt.12.9.1975.
              3.    The words 'surcharge on such tax' deleted by G.O.Ms.No.244  Rev.dt.17.5.1995.
              4.    Subs. for the expression "see Rule 15" by G.O.Ms.No.1445, Rev., dt.5.11.1986.
              5.     Subs. for the expression "Form A-1" ibid.
              6.    Subs. by G.O.Ms.No.1445, Rev.dt.5.11.1986.
              7.    Subs. by G.O.Ms.No.101 Rev.dt.2.2.1989 for the words "bankers cheque".
              8.    Col.4 was subs. by G.O.Ms.No.688, Rev.dt.11.10.1988.  By the same G.O. the words "by money order
                     to the undersigned or" and "to the DCTO/ACTO/Bill Collector or" were omitted.
              9.    Ins. by G.O.Ms.No.1081 Rev. dt.4.11.1993.
             10.   Subs. by G.O.Ms.No.244 Rev.dt.17.5.1995.