FORM ST-3

(IN TRIPLICATE)

(Return under section 70 of the Finance Act, 1994)

(Please see the instructions carefully before filling the Form)

[ORIGINAL / REVISED RETURN (Strike whichever is NOT applicable)]

Financial Year

For the period (Please tick the appropriate period)

April-September

October- March

Has the assessee opted to operate as Large Taxpayer [Y/N]

(As defined under Rule 2 (ea) of the Central Excise Rules, 2002 read with rule 2 (1)(cccc) of the Service Tax Rules, 1994)

1B	If reply to column “1A” is ‘yes’, name of Large Taxpayer Unit (LTU) opted for
	(name of city)

2A.

Name of the assessee

STC No.

Premises code No.

Constitution of assessee

(i)

Individual/

(ii)

Partnership

(Please tick the appropriate

Proprietary

category)

(iii)

Registered Public

(iv)

Registered Private Ltd

Ltd Company

Company

(v)

Registered Trust

(vi) Society/ Co-op Society

(vii)

Other

3. Computation of Service Tax (To be filled by a person liable to pay service/Not to be filled by input service distributor)

(To be repeated for every category of taxable service on which service tax is payable by the assessee)

Name of Taxable service

Assessee is liable to pay service tax on this taxable service as,- (Please tick the appropriate category)

(i) a service provider; or

(ii) a service receiver liable to make payment of service tax

Sub-clause No. of clause (105) of section 65 (Please see instructions)

Has the assessee availed benefit of any exemption notification (‘Y/N’)

If reply to column “C1” is ‘yes’, please furnish notification Nos.

If abatement is claimed as per notification No. 1/2006-ST, please furnish Sr. No. in

the notification under which such abatement is claimed

Whether provisionally assessed (‘Y/N’)

Prov. assessment order No.

(‘if any’)

F Value of taxable service, service tax payable and gross amount charged

	Month/Quarter**	Apr/ Oct	May/ Nov	June/ Dec	July/ Jan	Aug/ Feb	Sept/ Mar
	(1)	(2)	(3)	(4)	(5)	(6)	(7)
(I)	Service tax payable
(a)	Gross amount received/(paid^#) in money
	(i) against service provided
	(ii) in advance for service to be provided
(b)	Money equivalent of considerations received/(paid^#) in a form other than money
(c)	Value on which service tax is exempt/not payable
	(i) Amount received against export of service^
	(ii) Amount received/(paid^#) towards exempted service (other than export of service, i.e., (i) above)
	(iii) Amount received as/(paid to^#) pure agent (Please see instructions)
(d)	Abatement amount claimed
(e)	Taxable value =(a+b) minus (c+d)
(f)	Service tax rate wise break-up of taxable value =(e)
	(i) Value on which service tax is payable @ 5%
	(ii) Value on which service tax is payable @ 8%
	(iii) Value on which service tax is payable @ 10%
	(iv) Value on which service tax is payable @ 12%
	(v) other rate, if any, (please specify)
(g)	Service tax payable= (5% of f(i)+ 8% of f(ii)+ 10% of f(iii) +12% of f(iv)+ f(v)X other rate)
(h)	Education cess payable (@ 2% of Service tax)
(i)	Secondary and higher education cess payable (@ 1% of Service Tax) (Please see instructions)

(II)	Taxable amount charged
(j)	Gross amount for which bills/invoices/challans are issued relating to service provided/ to be provided (including export of service and exempted service)
(k)	Money equivalent of other consideration charged, if any, in a form other than money
(l)	Amount charged for exported service provided/ to be provided ^
(m)	Amount charged for exempted service provided/ to be provided (other than export of service given at (l) above)
(n)	Amount charged as pure agent (Please see instructions)
(o)	Amount claimed as abatement
(p)	Net taxable amount charged =(j+k) minus(l+m+n+o)

** Assessee liable to pay service tax on quarterly basis may furnish details quarter wise i.e. Apr-Jun, Jul-Sep, Oct-Dec, Jan-Mar

# Applicable when service receiver is liable to pay service tax; ^ Not applicable to service receiver liable to pay service tax

4. Amount of service tax paid in advance under sub-rule(1A) of rule 6

	Month/Quarter**	Apr/ Oct	May/ Nov	June/ Dec	July/ Jan	Aug/Feb	Sept/Mar
	(1)	(2)	(3)	(4)	(5)	(6)	(7)
(a)	Amount deposited in advance
(b)	Challan Nos.
(c)	Challan dates

** Assessee liable to pay service tax on quarterly basis may furnish details quarter wise i.e. Apr-Jun, Jul-Sep, Oct-Dec, Jan-Mar

4A. Service Tax, education cess and other amounts paid (To be filled by a person liable to pay service tax/Not to be filled by input service distributor)

Month/Quarter**

Apr/ Oct

May/

Nov

June/

Dec

July/

Jan

Aug/

Feb

Sept/

Mar

(1)

(2)

(3)

(4)

(5)

(6)

(7)

(I)

Service tax, education cess, secondary and higher education cess paid

(a)

Service Tax paid-

(i) in cash

(ii) by CENVAT credit^

(iia)by adjustment of amount earlier paid in advance and adjusted in this period under rule 6 (1A).

(iii) by adjustment of excess amount paid earlier and adjusted in this period under Rule 6 (3) of ST Rules

(iv) by adjustment of excess amount paid earlier and adjusted in this period under Rule 6 (4A) of ST Rules

(b)

Education cess paid -

(i) in cash

(ii) by CENVAT credit^

(iia)by adjustment of amount earlier paid in advance and adjusted in this period under rule 6 (1A)

(iii) by adjustment of excess amount paid earlier and adjusted in this period under Rule 6 (3) of ST Rules

(iv) by adjustment of excess amount paid earlier and adjusted in this period under Rule 6 (4A) of ST Rules

(c)

Secondary and higher education cess paid -

(i) in cash

(ii) by CENVAT credit^

(iia)by adjustment of amount earlier paid in advance and adjusted in this period under rule 6 (1A)

(iii) by adjustment of excess amount paid earlier and adjusted in this period under Rule 6 (3) of ST Rules

(iv) by adjustment of excess amount paid earlier and adjusted in this period under Rule 6 (4A) of ST Rules

(d)

Other amounts paid

(i) Arrears of revenue paid in cash

(ii) Arrears of revenue paid by credit^

(iii) Arrears of education cess paid in cash

(iv) Arrears of education cess paid by credit^

(v) Arrears of Sec & higher edu cess paid by cash

(vi) Arrears of Sec & higher edu cess paid by credit

(v) Interest paid

(vi) Penalty paid

(vii) Section 73A amount paid^

(viii) Any other amount (please specify)

(II)

Details of Challan (Vide which service tax education cess , secondary and higher education cess and other amounts paid in cash)

(a)

Challan Nos

(i)

(ii)

(iii)

(iv)

(b)

Challans Date (May please be furnished in the order of Challan Nos furnished above)

(i)

(ii)

(iii)

(iv)

** Assessee liable to pay service tax on quarterly basis may give detail quarter wise i.e. Apr-Jun, Jul-Sep, Oct-Dec, and Jan-Mar

^ Not applicable to service receiver liable to pay service tax

4B. Source documents details for entries at column 4A(I)(a) (iii), 4A(I)(a) (iv), 4A(I)(b) (iii), 4A(I)(b) (iv), 4A(I)(c) (iii), 4A(I)(c) (iv), 4A(I)(d) (i) to (vii)

(To be filled only if any entry is made against column 4A(I)(a) (iii), 4A(I)(a) (iv), 4A(I)(b) (iii), 4A(I)(b) (iv), 4A(I)(c) (iii), 4A(I)(c) (iv), 4A(I)(d) (i) to (vii))

Entry in table 4A	above	Source documents No./Period	Source documents date
S No.	Month/Quarter

4C. Details of amount of service tax payable but not paid as on the last day of the period for which return is filed……………………………………………………………..

5. Details of input stage CENVAT credit (To be filled by a taxable service provider only/ not to be filled by service receiver liable to pay service tax or input service distributor)

5A. Whether the assessee providing exempted/non taxable service or exempted goods

	(1)	(2)
(a)	Whether providing any exempted or non taxable service (‘Y/N’)
(b)	Whether manufacturing any exempted goods (‘Y/N’)
(c)	If any one of the above is yes, whether maintaining separate account for receipt or consumption of input service and input goods (refer to rule 6 (2) of CENVAT credit Rule, 2004
(d)	If any one of the (a) and (b) is ‘yes’, and (c) is ‘no’, which option is being availed under rule 6 (3) of the Cenvat Credit Rules, 2004
	(i) Opted to pay an amount equal to 10% of the value of exempted goods and 8% of the value of exempted service (Y/N); or
	(ii) Opted to pay an amount equivalent to CENVAT Credit attributable to inputs and input services used in or in relation to manufacture of exempted goods or provision of exempted service (Y/N).

5AA Amount payable under rule 6 (3) of the Cenvat Credit Rules, 2004

	Month	Apr/ Oct	May/ Nov	June/ Dec	July/Jan	Aug/Feb	Sept/Mar
	(1)	(2)	(3)	(4)	(5)	(6)	(7)
(a)	Value of exempted goods cleared
(b)	Value of exempted services provided
(c)	Amount paid under rule 6(3) of Cenvat Credit Rules, 2004, by CENVAT Credit
(d)	Amount paid under rule 6(3) of Cenvat Credit Rules, 2004, by cash
(e)	Total amount paid= (c) +(d)
(f)	Challan Nos, vide which amount mentioned in (d) is paid
(g)	Challan dates						”.

5B. CENVAT Credit taken and utilized

	Month/Quarter**	Apr/ Oct	May/ Nov	June/ Dec	July/ Jan	Aug/ Feb	Sept/ Mar
	(1)	(2)	(3)	(4)	(5)	(6)	(7)
(I)	CENVAT Credit of Service Tax and Central Excise duty
(a)	Opening balance
(b)	Credit taken
	(i) On inputs
	(ii) On capital goods
	(iii) On input services received directly
	(iv) As received from input service distributor
	(v) From inter unit transfer by a LTU*

April-September

Taxable value =(a+b) minus (c+d)

Service tax rate wise break-up of taxable value =(e)

(i) Value on which service tax is payable @ 5%

(ii) Value on which service tax is payable @ 8%

(iii) Value on which service tax is payable @ 10%

(iv) Value on which service tax is payable @ 12%

(v) other rate, if any, (please specify)

Service tax payable= (5% of f(i)+ 8% of f(ii)+ 10% of f(iii) +12% of f(iv)+ f(v)X other rate)

Education cess payable (@ 2% of Service tax)

Gross amount for which bills/invoices/challans are issued relating to service provided/ to be provided (including export of service and exempted service)

Money equivalent of other consideration charged, if any, in a form other than money

Amount charged for exported service provided/ to be provided ^

Amount charged for exempted service provided/ to be provided (other than export of service given at (l) above)

Amount charged as pure agent (Please see instructions)

Amount claimed as abatement

Net taxable amount charged =(j+k) minus(l+m+n+o)

Other amounts paid

Source documents No./Period

Opening balance

Credit taken

(i) On inputs

(ii) On capital goods

(iii) On input services received directly

(iv) As received from input service distributor

(v) From inter unit transfer by a LTU*