Certificate under sub-section (2) of section 6

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..... the dealer receiving the certificate Original To be furnished to the prescribed authority Name of State ................................................... Serial No .......................................................... [To be issued (in duplicate) (i) by the selling dealer who first moved the goods in the case of a sale fallin .....

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..... ....................................... (ii) Description, quantity and value of goods ....................... ................... (iii) No. and date of the declaration form C received from purchasing dealer with name of State of issue .. ...................... ...... (iv) No. and date of the Railway Receipt/Trip sheet of lorry/or any document of other means of transport .... .....

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..... ............................................................................ The above statements are true to the best of my knowledge and belief. (Signature) (Name of the person signing the certificate) . .. (Place) .. .. (Status of the person signing the certificate in relation to the dealer) .. .. Dated ........................... Address (with .....

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