Form GSTCMP-04

[See rule 6(2) ]

 

Intimation/Application for Withdrawal from Composition Levy

 

 

1. GSTIN
2.  Legal name
3. Trade name, if any
4.Address of Prin­ci­pal Place of business
5. Cat­e­go­ry of Reg­is­tered Person
(i)         Man­u­fac­tur­ers, oth­er than man­u­fac­tur­ers of such goods as may be noti­fied by the Government  

 

(ii)         Sup­pli­ers mak­ing sup­plies referred to in clause (b) of para­graph 6 of Sched­ule II  
(iii)       Any oth­er sup­pli­er eli­gi­ble for com­po­si­tion levy.  
6. Nature of Business
7. Date from which with­draw­al from com­po­si­tion scheme is sought DD MM YYYY
8.  Juris­dic­tion Cen­tre State
9. Rea­sons for with­draw­al from com­po­si­tion scheme
10. Ver­i­fi­ca­tion

I                                                                         here­by  solemn­ly  affirm  and  declare    that  the infor­ma­tion giv­en here­in­above is true and cor­rect to the best of my knowl­edge and belief and noth­ing has been con­cealed therefrom.

Sig­na­ture of  Autho­rised Signatory

 

Name

Place Date

Des­ig­na­tion / Status

 

 

Note – Stock state­ment may be fur­nished sep­a­rate­ly for avail­ing input tax cred­it on the stock avail­able on the date pre­ced­ing the date from which com­po­si­tion option is with­drawn in FORM GST ITC ‑01.

Down­load Form GSTCMP-04 in Word Format

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