FORM-VI-C
[See Rule 15-A]
[Month Return to be filled by the Master Cable Operator]
To
The Entertainments Tax Officer.
…………………………………,
………………………………….
Sir,
I …………. Son of …………….. on behalf of the Master Cable Operator of ………… situated in ………………. Mandal of ………….. District of …………… furnish herewith the following particulars and the extract of the Register in Form V-A for the month of ……………….. and enclosed crossed Cheque/Demand Draft/Treasury receipt bearing No. ………….. date ………….. for an amount of Rs. …………… towards the payment of the tax due for the month ………
STATEMENT OF NUMBER OF SUBCRIBERS CONNECTIONS
No. of connections No. of connections Balance No. of connections
at the beginning disconnected given during
of the month during the month the month
1 2 3 4
Total No. of Rate of tax Tax due Amount paid
connections
5 6 7 8
Enclosures:- (i) Extract of Register in Form V-A.
(ii Challan/Cheque/Demand Draft.
STATEMENT SHOWING THE DETAILS OF EXTENSION OF CABLE T.V. NETWORK
[See Rule 9C(1)]
{To be filled in only when there is change in the peripheral limits of Cable Network}
Existing Details of Details No. of additional
Peripheral Addl. Peripheral of additional connections given/
limits of area proposed equipment proposed to be given
area covered to be covered introduced
by T.V.Net by the (Outer limits of cable network in terms of streets or
work of the proprietor. lanes it covers shall be indicated)
proprietor.
1 2 3 4
STATEMENT SHOWING THE DETAILS OF SUBSCRIBERS WHOSE
CONNECTIONS HAVE BEEN DISCONNECTED
[See Rule 9E(1)]
Sl. Name and Date from Whether discontinued at the
No. Address of which Cable request of the subscriber or for
the subscriber connection is default of subscription or any
discontinued other reason
(Specify reasons)
1 2 3 4
DECLARATION
I ………………… declare that to the best of my knowledge and belief the information furnished above is true, correct and complete.
Signature
Status and relation to the
Master Cable Operator.