Form Xxxiv - Indemnity Bond
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1
2FORM XXXIV
TRIPURA VALUE ADDED TAX ACT, 2004
INDEMNITY BOND
( Under Rule 53 of TVAT Rules, 2005 )
Know all men by these presents I ______________________________________________________
S/o. _____________________________________ registered dealer under the Tripura VAT Act, 2004
under the TIN____________________ (hereinafter called the Obligor is / are held and firmly bound unto
Government of Tripura (hereinafter called the Government) in sum of ___________ (in figures) Rupees
______________________(in words) well and truly to be paid to the Government on demand and
without demur for which payment to be well and truly made I bind myself and my heirs, executors,
administrators, legal representatives and assign / We bind ourselves, our successors and assign and the
person for the time being having control over our assets and affairs.
Signed this _________________ day of ____________ Two thousand and ____________.
Whereas rule 53 of the Tripura VAT Rules, 2005 requires that in the event of a blank of a duly completed
form of declaration is lost while it is in the custody of the dealer or in transit to the selling / purchasing
dealer, to furnish an indemnity bond to the authority from whom the said form was obtained.
And whereas the obligor here is such dealer, and whereas the obligor has lost the declaration in
Form ____ bearing No.____________________ which was blank / duly completed, and was issued to
him by _______________( Name and destination of the authority) ______________________ in respect
of the goods mentioned below (hereinafter referred to as the “FORM”.
Sl.No.
No. of Bill /
Date
Description of
Quantity
Amount
invoice challan
goods
(1)
(2)
(3)
(4)
(5)
(6)
Now the condition of the above written bond of obligation is such that the obligor shall in the event of a
loss suffered by the Government (in respect of which the decision of the Government or the authority
appointed for the purpose shall be final and binding on the obligor) as a result of the misuse of the form.
Pay to the Government on demand and without demur the said sum of Rs.______________ Rupees
_____________(in words) and shall otherwise indemnify and keep the Government harmless and
indemnify against and from all liabilities incurred by the Government as a result of the misuse of such
form. Then the above written bond or obligation shall be void and of no effect but otherwise shall remain
in full force, effect but otherwise shall remain in full force, effect and virtue. The obligor further undertakes
to mortgage / charge, the properties specified in the schedule hereunder written by execution of proper
deed or mortgage / charge for the payment of the said sum whenever called upon to do so by the
assessing authority.
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