GST PMT - 04, Integrated Tax (GST-FORMS)

1. GSTIN 2. Name (Legal) 3. Trade name, if any 4. Ledger / Register in which discrepancy noticed __Credit ledger register __ Cash __ Ledger liability 5. Details of the discrepancy Date Type of tax Type of discrepancy Amount involved Central Tax State Tax UT Tax Integrated Tax Cess 6. Reasons, if any 7. 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. Signature Name of Authorized Signatory Designation /Status……………… Place Date Note – ‘Central Tax’ stands for Central Goods and Services Tax; ‘State Tax’ stands for State Goods and Services Tax; ‘UT Tax’ stands for Union territory Goods and Services Tax; ‘Integrated Tax’ stands for Integrated Goods and Services Tax and ‘Cess’ stands for Goods and Services Tax(Compensation to States)