| COUNTERFOILTHE 
      CENTRAL SALES TAX
 (Registration & Turnover)
 RULES, 
      1957.
 53FORM 'D'
 FORM OF CERTIFICATE 
      FORMAKING GOVERNMENT
 PURCHASES
 [See Rule 12(1)](to 
      be used when making purchases
 by Government not being a 
      registered
 dealer)
 
 Central Government / Name of 
      the
 State Govt.............................Name
 of 
      Issuing Ministry / Department
 Name and address of office 
      ofissue 
      ....................................................
 To
 $ 
      .......................................... 
      (Seller)
 .....................................................
 Certified 
      that the goods
 [** Ordered for in our 
      purchase
 order No ........................ dated 
      .................... 54[and supplied as
 per Bill / 
      Cash Memo
 / Challan No .................. 
      dated............................  as stated
 below:]
 / 
      purchased from you as per bill /
 Cash memo stated below * 
      supplied
 under your challan No ...................
 dated 
      ................................ are
 purchased  by or on 
      behalf of the Government of ...............................
 Date ................ Signature 
      ...............   Designation of the 
      AuthorisedOfficer of the Government.
 SEAL OF THE DULY ATHORISED OFFICER OF 
      THE GOVERNMENT______________________________
 *Particulars of Bill / 
      Cash Memo.
 Date 
      ............................ No ............
 Amount 
      ............................................
 $Name and address of the 
      sellerwith name of the State.  **Strike 
      out
 whichever is not applicable.
 (Note:-   
      To be retained by theauthorised officer.)
   | DUPLICATETHE CENTRAL 
      SALES TAX
 (Registration & Turnover)
 RULES, 
      1957.
 53FORM 'D'
 FORM OF CERTIFICATE 
      FORMAKING GOVERNMENT
 PURCHASES
 [See Rule 12(1)](to 
      be used when making purchases
 by Government not being a 
      registered
 dealer)
 
 Central Government / Name of 
      the
 State Govt.............................Name
 of 
      Issuing Ministry / Department
 Name and address of office 
      ofissue 
      ....................................................
 To
 $ 
      .......................................... 
      (Seller)
 .....................................................
 Certified 
      that the goods
 [** Ordered for in our 
      purchase
 order No ........................ dated 
      .................... 54[and supplied as
 per Bill / 
      Cash Memo
 / Challan No .................. 
      dated............................  as stated
 below:]
 / 
      purchased from you as per bill /
 Cash memo stated below * 
      supplied
 under your challan No ...................
 dated 
      ................................ are
 purchased  by or on 
      behalf of the Government of ...............................
 Date ................ Signature 
      ...............   Designation of the 
      AuthorisedOfficer of the Government.
 SEAL OF THE DULY ATHORISED OFFICER OF 
      THE GOVERNMENT______________________________
 *Particulars of Bill / 
      Cash Memo.
 Date 
      ............................ No ............
 Amount 
      ............................................
 $Name and address of the 
      sellerwith name of the State.  **Strike 
      out
 whichever is not applicable.
 (Note:-   
      To be retained by theselling dealer.)
   
   | ORIGINALTHE CENTRAL 
      SALES TAX
 (Registration & Turnover)
 RULES, 
      1957.
 53FORM 'D'
 FORM OF CERTIFICATE 
      FORMAKING GOVERNMENT
 PURCHASES
 [See Rule 12(1)](to 
      be used when making purchases
 by Government not being a 
      registered
 dealer)
 
 Central Government / Name of 
      the
 State Govt.............................Name
 of 
      Issuing Ministry / Department
 Name and address of office 
      ofissue 
      .............................................
 To
 $ 
      .......................................... 
      (Seller)
 .....................................................
 Certified 
      that the goods
 [** Ordered for in our purchase
 order No 
      ........................ dated .................... 54[and 
      supplied as
 per Bill / Cash Memo
 / Challan No 
      .................. dated............................  as 
      stated
 below:]
 / purchased from you as per bill /
 Cash 
      memo stated below * supplied
 under your challan No 
      ...................
 dated ................................ 
      are
 purchased  by or on behalf of the Government of 
      ...............................
 Date ................ Signature 
      ...............  Designation of the 
      AuthorisedOfficer of the Government.
 SEAL OF THE DULY ATHORISED OFFICER OF 
      THE GOVERNMENT______________________________
 *Particulars of Bill / 
      Cash Memo.
 Date 
      ............................ No ............
 Amount 
      ............................................
 $Name and address of the 
      sellerwith name of the State.  **Strike 
      out
 whichever is not applicable.
 (Note:-   
      To be furnished to the prescribed authority in 
      accordance
 with the rules framed under
 section 13(3) by 
      the appropriate
 State 
  Government)
 
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