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[April-September] |
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[October-March] |
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| 1. |
Name of the assessee |
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| 2. |
Registration Numbers of premises for which return is being filed |
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| 3. |
Category of taxable services for which return is being filed: |
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(Mention all the taxable services provided/received) |
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(1)________________________________
(2)________________________________
(3)________________________________ |
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| 4. |
Payment of Service Tax |
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Category of Service: __________________________________________________ |
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| (A) |
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Payment details |
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Apr/Oct |
May/Nov |
June/Dec |
July/Jan |
Aug/Feb |
Sept/Mar |
Total of column (2) to (7) |
(1) |
(2) |
(3) |
(4) |
(5) |
(6) |
(7) |
(8) |
Amount received towards taxable service(s) provided |
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Amount received in advance towards taxable service(s) to be provided |
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Amount Billed- gross |
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Amount billed for exempted services other than export |
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Amount billed for exported services, without payment of tax |
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Amount billed for services on which tax is to be paid |
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Abatement claimed- Value |
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Notification number of Abatement |
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Notification number of exemption |
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Provisional Assessment order no. |
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Service tax payable |
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Education cess payable |
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Service tax paid in cash |
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Challan Number |
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Challan date |
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Service tax paid through cenvat credit |
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Education cess paid in cash |
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Education cess paid through education cess credit |
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(To be repeated for every category of service provided /received, and for every registered premises separately) |
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| (B) |
Details of other payments |
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Amount-Cash |
Challan Number |
Date |
Amount-Credit |
Source Document No |
(1) |
(2) |
(3) |
(4) |
(5) |
(6) |
Arrear of service tax |
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Education cess |
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Interest |
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Not applicable |
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Penalty |
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Not applicable |
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Miscellaneous |
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Not applicable |
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Excess amount paid and adjusted subsequently** |
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Total |
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** Under rule 6(4A) of Service Tax Rules, 1994 |
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(To be repeated for every category of service provided /received, and for every registered premises separately) |
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| 5. |
Credit details for Service Tax provider/recipient |
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| (A) |
Cenvat credit details |
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Details of Credit |
Apt/Oct |
May/Nov |
June/Dec |
July/Jan |
Aug/Feb |
Sept/Mar |
(1) |
(2) |
(3) |
(4) |
(5) |
(6) |
(7) |
Opening Balance |
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Credit availed on inputs |
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Credit availed on capital goods |
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Credit availed on input services |
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Credit received from inputs service distributor |
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Total credit availed |
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Credit utilized towards payment of service tax |
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Closing balance |
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| (B) |
Education cess credit details |
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Details of Credit |
Apt/Oct |
May/Nov |
June/Dec |
July/Jan |
Aug/Feb |
Sept/Mar |
(1) |
(2) |
(3) |
(4) |
(5) |
(6) |
(7) |
Opening Balance |
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Credit of education cess availed on goods |
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Credit of education cess availed on services |
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Credit of education cess utilized for payment of service tax |
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Closing Balance |
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| 6. |
Credit details for Input service distributor |
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| (A) |
Details of Cenvat credit received and distributed |
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Details of Credit |
Apt/Oct |
May/Nov |
June/Dec |
July/Jan |
Aug/Feb |
Sept/Mar |
(1) |
(2) |
(3) |
(4) |
(5) |
(6) |
(7) |
Opening Balance |
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Credit of service tax received |
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Credit of service tax distributed |
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Credit of service tax not eligible to be distributed* |
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Closing Balance |
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| (B) |
Details of Education cess received and distributed. |
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Details of Credit |
Apt/Oct |
May/Nov |
June/Dec |
July/Jan |
Aug/Feb |
Sept/Mar |
(1) |
(2) |
(3) |
(4) |
(5) |
(6) |
(7) |
Opening Balance |
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Credit of education cess received |
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Credit of education cess distributed |
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Credit of education cess not eligible to be distributed* |
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Closing Balance |
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*as per rule 7(b) of CENVAT Credit Rules, 2004 |
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| (C) |
The taxable services on which input service credit has been distributed during the half year period
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| 7. |
Details of amount payable but not paid as on the last day of the period for which the |
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Return is filed _______________________________________________ |
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| 8. |
Self Assessment memorandum |
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| (a) |
I/We declare that the above particulars are in accordance with the records and books maintained by me/us and are correctly stated. |
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| (b) |
I/We have assessed and paid the service tax and/or availed and distributed CENVAT credit correctly as per the provisions of the Finance Act, 1994 and the rules made thereunder. |
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| (c) |
I/We have paid duty within the specified time limit and in case of delay, I/We have deposited the interest leviable thereon. |
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Place: (Name and Signature of Assessee or
Date: Authorized Signatory) |
