GST REG - 12, Integrated Tax (GST-FORMS)

To (Name): (Address): Temporary Registration Number Order of Grant of Temporary Registration/ Suo Moto Registration Whereas the undersigned has sufficient reason to believe that you are liable for registration under the Act, and therefore, you are hereby registered on a temporary basis. The particulars of the business as ascertained from the business premises are given as under: Details of person to whom temporary registration granted 1. Name and Legal Name, if applicable 2. Gender Male/Female/Other 3. Father’s Name 4. Date of Birth DD/MM/YYYY 5. Address of the Person Building No./ Flat No. Floor No. Name of Premises/ Building Road/ Street Town/City/Locality/ Village Block / Taluka District State PIN Code 6. Permanent Account Number of the person, if available 7. Mobile No. 8. Email Address 9. Other ID, if any (Voter ID No./ Passport No./Driving License No./ Aadhaar No./ Other) 10. Reasons for temporary registration 11. Effective date of registration / temporary ID 12. Registration No. / Temporary ID 1[13. Details of Bank Accounts (s) [Optional] Total number of Bank Accounts maintained by the applicant (Upto 10 Bank Accounts to be reported) Details of Bank Account 1 Account Number Type of Account IFSC Bank Name Branch Address To be auto-populated (Edit mode) Note-Add more bank accounts] (Upload of Seizure Memo / Detention Memo / Any other supporting documents) < order>> Signature << Name of the Officer>>: Designation/ Jurisdiction: Place Date: Note: A copy of the order will be sent to the corresponding Central/ State Jurisdictional Authority. Notes 1. Inserted vide Notification No. 31/2019 – Central Tax dated 28-06-2019 w.e.f. 28.6.2019