FORM ST- 1 Application for
registration under section 69 of the Finance Act, 1994 ( 32 of
1994)
1.
Name of the assessee
:
2.
Address of the assessee
:
2a.
Pan Number
:
3.
Address of the premises to be registered
:
4.
Category of the service
:
5.
Fax / telex and phone number
:
6.
Form of organization (individual /company /
partnership, etc.)
:
7.
Additional information required in the case of
stock-broker
:
a) Name of the member, with code
No.
:
b) Name of stock exchange registered
with
:
c) Date of admission of
membership
:
d) Whether member of more than one
stock exchange? If so, please
give name of the stock exchange with code number
:
e)
Registration number allotted by
Securities and Exchange Board of India (copy of certificate of registration may be enclosed
or a copy of application for registration with SEBI may be enclosed)
:
8.
I/ We _________________________ agree to
abide by all the provisions of Service Tax Rules, 1994, and
any order issued there under.
9.
I/ We ________________declare to the best of
my / our knowledge and belief that the information furnished
herein is true and complete.
Place :
Date :
Signature of assessee
or his authorized
representative