1 10272154182 PDF
1 10272154182 PDF
1 10272154182 PDF
1-10272154182_SRN_FORM
AGILE‐PRO-S English Hindi
(Application for Goods and services tax Identification number , employees state Insurance corporation registration
pLus Employees provident fund organisation registration, Profession tax Registration, Opening of bank account and
Shops and Establishment Registration)
4 State Jurisdiction
5 Centre Jurisdiction
Commissionerate
Division
Range
Yes No
7 *Whether the Establishment on Lease
Leased to Date
If selected others,
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b Proof of Principal place of Business
(Property Tax Receipt (TAXR)/Municipal Khata copy (CMUK),
Electricity Bill (ELCB)/ Rent/ Lease Agreement (RLAT),
Consent Letter (CNLR)/Rent receipt with NOC (In case of no/expired agreement) (RNOC),
Legal ownership document (LOWN)
If hired or there is a change in the name of unit/ ownership, please indicate Yes No
Leased from Date
01/06/2023
Leased to Date
30/04/2024
I hereby declare that aforesaid business shall abide by the conditions and restrictions specified in the Act or Rules for opting to
pay tax under the composition levy.
9 Nature of Business Activity being carried out at above mentioned Premises (Please tick applicable)
Factory / Manufacturing,
Wholesale Business ,
Retail Business ,
Warehouse / Depot,
Bonded Warehouse,
Supplier of Services,
Office / Sale Office,
Leasing Business
Recipient of goods or services,
EOU / STP / EHTP,
Works Contract,
Export,
Import,
Others (Please specify)
Description of Goods
Description of Services
DIN
BTKPD1671C
*PAN
SABITRI
*First Name
Middle Name
*Last Name
KUMARI
*Personal Email ID
SA******************IL.COM
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*Photograph PHOTO.jpeg
(Either of the following document can be attachedLetter of Authorization/Copy of Resolution passed by BoD/Managing Committee and
Acceptance letter)
DIN
Middle Name
*Personal Email ID
14 Employer’s Particulars
15 Bank Particulars
*Proof of Identity of Authorized Signatory for opening Bank Account SATEYENDRA PAN.pdf
*Proof of Address of Authorized Signatory for opening Bank Account BANK STATEMENT.pdf
a Category of Establishment
b Nature of Business
Declaration
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*Place AGRA
*Date
03/08/2023
*Designation
Director
DIN2
*DIN/PAN BTKPD1671C
(Authorized Signatory / Primary Owner / Office Bearer signing the SPICe+ ‐AGILE‐PRO-S form shall provide his Permanent Account
Number)
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