Government of Goa
Commercial Taxes Department
Application for VAT Registration
Dealer Personal Details
Select Ward Office*
Type of Registration*                             Applicant Status
Name of the Applicant*
Father's/ Mother's/ Husband's Name    
Date of Birth/ Incorporation/ Constitution                        Sex( M or F)
Challan No. *                   
Challan Date*          Amount (Rs.)*
Name & Style of Business*  
Principal Place of Business
Address Type
Address *
District *                                             Taluka *
PIN Code           
Contact Details
Telephone                                 Mobile No *
Fax Number   
Email Address          
Residential Address 
District                            State 
PIN Code  
Business Details
Aadhaar No.
Constitution of Business*
Nature of Business*
Permanant Account Number of the business under Income Tax Act (PAN) *      
Name of the Statutory Authority with whom already registered 
Turnover of sales during the year [YYYYYY]  
Turnover Amount   
Turnover exceeded the limit (provided under Section 3) on  
The Business is succeeded from the Dealer  
Business succeeded with effect from  
TIN of the dealer from whom the Business is succeded   
Date of Commencement of Business  
Enclosure Details
Accounting Period

Major Commodity Details
 Select Commodity  
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