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AHMEDABAD MUNICIPAL CORPORATION MAHANAGAR SEVA SADAN FORM 3 Passport size Photo An application for a Certificate of Enrolment/ Revision of Certificate of Enrolment under sub -section 2 of section 5 o f the Gujarat State tax on Professions Trades Callings and Employments Act 1976 See rule 4- 1 I hereby apply for a certificate of enrolment under the Gujarat State tax on Professions Trades Callings and Employment s Act 1976 as per Particulars given below - 1. Old Prof* Tax No*. 2. Prof Tax No of AMC 3. New Reg* Name of the Applicant Commencement Date AMC Tena* No* Establishment Name Address -1 Building Street Muni. Ward Ahmedabad Town/ City Taluka District PIN Mobile No* E-Mail Address of Additional Place Pl* attach sheet if required Profession/ Trade/ Calling/ Sub Entry No* Current Rs. Arrears Rs. Off* 1 If falling under entry 6 of Schedule 1 Details of business like 1 Registration No 2 No* of Employees. 3 Any Other. 2 Turnover of previous year. 2 Registration Authority. Pl* fill in this part in case application is for revision of certificate of enrolment Grounds on which revision is sought The above statements are true to the best of my knowledge and belief* Date Signature Acknowledgment Particulars of Name and Ad dress to be filled in by the applicant Received an application for enrolment in Form- 3from Full Postal Address Receiving Officer s signature Marked fields are Compulsory Status Res*. Old Prof* Tax No*. 2. Prof Tax No of AMC 3. New Reg* Name of the Applicant Commencement Date AMC Tena* No* Establishment Name Address -1 Building Street Muni. Ward Ahmedabad Town/ City Taluka District PIN Mobile No* E-Mail Address of Additional Place Pl* attach sheet if required Profession/ Trade/ Calling/ Sub Entry No* Current Rs. Ward Ahmedabad Town/ City Taluka District PIN Mobile No* E-Mail Address of Additional Place Pl* attach sheet if required Profession/ Trade/ Calling/ Sub Entry No* Current Rs. Arrears Rs. Off* 1 If falling under entry 6 of Schedule 1 Details of business like 1 Registration No 2 No* of Employees. Arrears Rs. Off* 1 If falling under entry 6 of Schedule 1 Details of business like 1 Registration No 2 No* of Employees. 3 Any Other. 2 Turnover of previous year. 2 Registration Authority. Pl* fill in this part in case application is for revision of certificate of enrolment Grounds on which revision is sought The above statements are true to the best of my knowledge and belief* Date Signature Acknowledgment Particulars of Name and Ad dress to be filled in by the applicant Received an application for enrolment in Form- 3from Full Postal Address Receiving Officer s signature Marked fields are Compulsory Status Res*. Old Prof* Tax No*. 2. Prof Tax No of AMC 3. New Reg* Name of the Applicant Commencement Date AMC Tena* No* Establishment Name Address -1 Building Street Muni. Ward Ahmedabad Town/ City Taluka District PIN Mobile No* E-Mail Address of Additional Place Pl* attach sheet if required Profession/ Trade/ Calling/ Sub Entry No* Current Rs. Arrears Rs. Off* 1 If falling under entry 6 of Schedule 1 Details of business like 1 Registration No 2 No* of Employees.

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