Form GST ITC-04 (Details of goods/capital goods sent to job worker and received back)

Form GST ITC-04

[See rule – 45(3)]

 

Details of goods/capital goods sent to job worker and received back

 

1. GSTIN -
2. (a) Legal name -

(b) Trade name, if any –

3. Peri­od: Quar­ter — Year -

 

4. Details of inputs/capital goods sent for job-work

 

GSTIN                      / State in case of unreg­is­tered job- worker	Chal­lan no.	Chal­lan date	Descrip­tion of goods	UQC	Quan­ti­ty	Tax­able value	Type of goods (Inputs/capital goods)	Rate of tax (%)
								Cen­tral tax	State/ UT tax	Inte­grat­ed tax	Cess
1	2	3	4	5	6	7	8	9	10	11	12

 

 

5. Details of inputs/capital goods received back from job work­er or sent out from busi­ness place of job-work

 

GSTIN / State of job work­er if unregistered	Received back/sent out to anoth­er job worker/ sup­plied from premis­es of job worker	Orig­i­nal chal­lan No.	Orig­i­nal chal­lan date	Chal­lan details if sent to anoth­er job worker			Invoice details in case sup­plied from premis­es of job worker		Descrip­tion	UQC	Quan­ti­ty	Tax­able value
				No.	Date	GSTIN/ State if job work­er unregistered	No.	Date
1	2	3	4	5	6	7	8	9	10	11	12	13

 

6. Ver­i­fi­ca­tion

 

 

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

 

 

Sig­na­ture

Place                                                                                                                      Name of Autho­rised Signatory ….……………………

Date                                                                                                                        Des­ig­na­tion /Status……………………………………

 

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