1. FORM ST-1
[Application form for registration under Section 69 of The Finance Act,1994(32 of 1994)]
IDENTIFICATION OF BUSINESS REQUIRING REGISTRATION
Name of Applicant : SHIV HUMAN RESOURCE SERVICES
Address of the Applicant : A-174 TEJENDRA VIHAR PART-1 VIRATNAGAR, NARODA, AHMEDABAD-382415
Details of Permanent Account Number(PAN) of the applicant
PAN Status : Allotted PAN : BAHPK3021P
Name of the Applicant(as appear-
ing in PAN) :
MAHENDRASINGH NARESHSINGH KUSHWAH
Constitution Of applicant : Proprietorship
Government Department Type :
Name of Trustee/Proprietor/HUF : MAHENDRASINGH
Category of Registrant : Service Provider
Nature of registration : Registration of a single premise
Taxable services provided : Manpower recruitment/supply agency service
ADDRESS OF PREMISES FOR WHICH REGISTRATION IS SOUGHT
Name Of Premises/Building : A-174 Flat / Door / Block No : TEJENDRA VIHAR
PART-1
Road / Street / Lane : Village / Area / Lane : VIRATNAGAR
Block / Taluk / Sub-Division /
Town :
NARODA Post Office : NARODA
City / District : AHMADABAD State / Union Territory : GUJARAT
PIN : 382415 Phone Number : 8734951104
Mobile Number : 8734951104 Fax Number-1 :
Fax Number 2 : Email Address : mahendras-
ingh6337@gmail.com
Commissionerate : SERVICE TAX -
AHMEDABAD
Division : SERVICE TAX DIVI-
SION-VI,AHMEDABAD
ST
Range : RANGE-IV
NAME, DESIGNATION AND ADDRESS OF AUTHORIZED SIGNATORIES
Name : MAHENDARSINGH Designation : Proprietor
Address : A-174 TEJENDRA VIHAR PART-1 VIRATNAGAR NARODA AHMEDABAD
Phone Number : 8734951104 Email Address : mahendrasingh6337@gmail.com
Declaration
I, MAHENDARSINGH,hereby declare that the information given in this application form is true,correct and com-
plete in every respect and that I am authorised to sign on behalf of the Registrant.
(a) For new Registration :I would like to receive the Registration Certificate by mail/by hand/E-MAIL
(b) For amendments to information pertaining to existing Registrant :Date from which amendments are made:
Date : 20/05/2016
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