GST ENR - 01, Integrated Tax (GST-FORMS)

1. Name of the State 2. (a) Legal name (b) Trade Name, if any (c) PAN (d) Aadhaar (applicable in case of proprietorship concerns only) 3. Type of enrolment (i) Warehouse or Depot (ii) Godown (iii) Transport services (iv) Cold Storage 4. Constitution of Business (Please Select the Appropriate) (i) Proprietorship or HUF (ii) Partnership (iii) Company (iv) Others 5. Particulars of Principal Place of Business (a) Address Building No. or Flat No. Floor No. Name of the Premises or Building Road or Street City or Town or Locality or Village Taluka or Block District State PIN Code Latitude Longitude (b) Contact Information (the email address and mobile number will be used for authentication) Email Address Telephone STD Mobile Number Fax STD (c) Nature of premises Own Leased Rented Consent Shared Others (specify) 6. Details of additional place of business – Add for additional place(s) of business, if any(Fill up the same information as in item 5 [(a), (b), and (c)] 7. Consent I on behalf of the holder of Aadhaar number give consent to “Goods and Services Tax Network” to obtain my details from UIDAI for the purpose of authentication. “Goods and Services Tax Network” has informed me that identity information would only be used for validating identity of the Aadhaar holder and will be shared with Central Identities Data Repository only for the purpose of authentication. 8. List of documents uploaded (Identity and address proof) 9. 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. Place: Date: Signature Name of Authorised Signatory For Office Use: Enrolment no Date-