FORM GST MOV-01
STATEMENT OF THE OWNER / DRIVER/
PERSON IN CHARGE
OF THE GOODS AND CONVEYANCE
Statement of Sri______________________ S/o______________ age _______years, residing at ____________________owner / driver / person- in- charge of the goods and conveyance bearing No. _____________________(Vehicle Number) made before the _________ (Designation of the proper officer) on DD/MM/YYYY at _________ AM/PM at ________________ (place).
Today, you have intercepted the above mentioned conveyance and after disclosing your identity, you have requested me to produce my credentials and the documents relating to the goods in movement for your verification.
In this regard, I hereby declare the following.
| 1. : Personal Details | ||||||
| NAME | ||||||
| FATHER’S NAME | ||||||
| AGE: | Yrs | DL NO: | RTO | |||
| Conveyance Registration No. | Engine No. | Chassis No. | ||||
| Proof of Identity | ||||||
| ADDRESS | ||||||
| Phone: | Email, If any | |||||
| 2.Details of the transporter: | ||||||
| NAME | ||||||
| ADDRESS | ||||||
| Phone: | ||||||
| 3 | I am the person-in-charge of the goods conveyance number |
/ / / |
||||
| 4 | I am transporting the goods from | |||||
| 5 | I have | a) not produced any documents relating to the goods under transportation | ||||
|
b) produced the documents, recorded in the Annexure, relating to the goods under transportation, which I have duly certified and signed as correct. |
||||||
I hereby further declare that, except the documents mentioned
in the Annexure to this statement which have been tendered to you, there are no
other documents with me or in the conveyance relating to the goods in movement.
The facts recorded in this statement are as per the submissions made by me and
the contents of the statement were explained to me once again in the
__________________ (language) which is known to me and I declare that the
information furnished in this statement is true and correct and I have retained
a copy of this statement.
(Owner/Driver/Person in charge)
“Before me”
Signature
Designation
ANNEXURE TO THE DEPONENT STATEMENT IN FORM GST MOV-01
|
PARTICULARS OF GOODS UNDER MOVEMENT- AS PER DOCUMENTS TENDERED |
|||||||||
| SL.NO. | LR NO | LR DATE | INVOICE/ BOS/DC NO. | INVOICE/BOS/DC DATE | CONSIGNOR | CONSIGNEE | COMMODITY | VALUE | EWB BILL NO, IF ANY |
| 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 |
“Before me”
(Owner/Driver/Person in charge)
Signature
Designation