EXCISE AND TAXATION DEPARTMENT Goverment of Himachal Pradesh

Form VAT-XXVI-A [See Rule 61(1)] DECLARATION Acknowledgement No. Acknowledgement Date and Time Form No. E26A1704120001095991 Type of Movement Goods Exported Nature of Transaction Goods for Trade Name CONSIGNOR 9170412000719107 17/04/2012 06:39:56 PM

INDO FARM EQUIPMENT LTD. 104, 105 Indl.Area, Baddi Tehsil.Baddi, Distt.Solan(H.P),Baddi,Himachal Pradesh 02030200748 Baddi

Consigned from Place

Full Address TIN(VAT/CST) Consigned From City Himachal Pradesh Name

Kesri Cahnd Bhanwarlal Near Radha Raman Temple Baragachhi 00000000000 Biratnagar Value of Goods (Rs.) 2602802.00

CONSIGNEE

Destination of Goods Checkpost / Barrier Details of Goods: Sr. No. 1 Vehicle No. HP55P6742 G.R. No. 1 1037

Full Address TIN(VAT/CST) Consigned To City Outside India Baddi

Bill No. 2 11102083

Quantity (vehicle wise) 3 4 31/03/2012 6 Date

Unit 5 Nos

Brief Description Of Goods 6 Tractors, threshers, harvesters and attachments and parts thereof

Value Of Goods (Rs.) (vehicle wise) 7 2602802.00

Transporter details: Sr. 1 Vehicle No. Name of Transporter Co. HP55P6742 ROOP LOGISTIC PVT LTD Address of Transporter Co. JAIPUR

Barrier Clearance Number: Signature or thumb impression ________________ Signature of Officer In-charge of the Name and address of the person transporting the goods. Checkpost/Barrier with stamp to be appended after checking. __________________________________________ __________________________________________ Date ____________________ Date ____________________ This is a computer generated Form VAT XXVI-A for which Rs. 10/- has been deducted/adjusted from the respective balance for e-declaration facility.