Application for refund of duty/interest

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....round of claim* : [*specify with details whether the claim is on account of reassessment of rates of duty/valuation, Shortage/Short-landing, Pilferage, appellate order, arithmetical/clerical error, any other ground (specify.] 7. Amount of refund claim : 8. Amount of Modvat credit availed from the additional duty of customs paid and : now covered by the refund claim 9. Enclosures* (in original) in support of refund claim : (*Please put a tick mark ( ) against the document being enclosed) (a) Letter of authorization from the importer/buyer in case the applicant is an agent. (b) Triplicate copy of Bill of Entry/Post parcel wrapper/Shipping Bill/Baggage Receipt or the Purchase Invoice (c) Duty Challan /Other document as e....

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.... contents of the refund claim as per form above are true and correct to the best of my/our information and belief; (b) the amount and the ground for which this refund claim has been filed has not been previously claimed and paid; and that (c) the excess duty claimed as refund has not been passed on to any other person by the importer/buyer. Signature of the applicant Date……………….. PART B [See Regulation 2(2)] ACKNOWLEDGEMENT FOR CUSTOM HOUSE USE FILE NO.................................... Refund claim of Mr/M/s..................…………........for Rs.……………….....against Bill of Entry/Post Parcel/ Baggage Form/Shipping Bi....