| 10A  Special  provision for registration and enrolment under Amnesty Scheme (1)  Where an employer or a person, other than a person earning salary or wages in  respect of whom tax is payable by his employer, who is liable to pay tax under  section 3, or section 4, or both, applies for registration or enrolment or both  under section 5, the provisions or rule 3 and rule 4, so far not inconsistent  with the provisions of section 5C, shall, mutatis mutandies, apply in the  manner of making the application and issue of the certificate of registration or  certificateof enrolment or both.       (2) The declaration to be submitted in accordance with sub-section (1) of  section 5C, together with the proof of payment of tax for the amount as  mentioned in sub-section (2) of that section, along with the application of  enrolment or registration or both shall be in the Form given below:-       FORM  OF DECLARATION       (See  rule 10A of the West Bengal State Tax on Professions, Trades, Callings   and  Employments Rules, 1979)       I,……………………………………………………………………………………  (name of the   applicant   with designation who has applied for registration on behalf of the  employer or name of the person who has applied for enrolment) holding the trade  name…………………………..   (if  any) and place of work  at…………………………………………………………...(address)   do  hereby declare that-          *I/We have incurred liability to pay tax under section 3, or section 4,  or both but have failed to apply for registration or enrolment or both under the  Act within 31.03.2014;       (1)   *I/We have applied for registration or enrolment or both under section 5  on……..(date) With the prescribed authority;       (2)  *my/our tax liability under section 5 read with section 5C comes as hereunder:-       
    
        
            | Sl.                       No.               | Particulars               | Liability        as an               employer               | Liability        as a               person               |  
            | (1)               | (2)               | (3)               | (4)               |  
            | (i)               | Tax        payable as person (Rs)               | XXXXXXXXX               |                 |  
            | (ii)               | Number        of employees as on 31.03.2014               |                 | XXXXXXXXX               |  
            | (iii)               | Tax        payable as employer (Rs)               |                 | XXXXXXXXX               |      *(3)   The *payment receipt/receipted challan  (No………………………………),showing payment of tax as person [Sl.  No.(i)], electronically / at the…………………………….(name of the  Bank / Treasury) on  ……………..………(date  of payment) is enclosed.       *(4)   The *payment receipt/receipted challan  (No………………………………),showing payment of tax as employer [Sl.  No. (iii)], electronically / at the……………………   (name of the Bank / Treasury) on ……………..………(date of  payment) is enclosed.           Certified  that the above particulars are true and correct to the best of my knowledge and  belief.       Date  :                                                                                                  (Signature of the declarant)       *Strike  out whichever is not applicable;   |