FORM
XXI
(See Rule 17(8) of
A.P.G.S.T. Rules, 1957)
Certificate
I
hereby certify that the following goods which are not held as stock by me on the
date given below are obtained from the dealers mentioned below and sold to the
customers who are not dealers.
I hereby undertake to pay
any penalty whatsoever in case it is noticed subsequently that the said sales
are not accommodation sales.
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S.
No. |
Name
and address of the dealer from |
Bill
No. &
Date. |
Way
Bill No. &
Date. |
Quantity. |
Value. |
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1. |
2. |
3. |
4. |
5. |
6. |
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