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 thereunder.

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