Application for Refund

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....ed On account of assessment/provisional assessment/ appeal/ any other order i. Select the type of Order: Assessment/ Provisional Assessment/ Appeal/ Others ii. Mention the following details: 1. Order No. 2. Order Date 3. Order Issuing Authority 4. Payment Reference No. (of the amount to be claimed as refund) (If Order is issued within the system, then 2, 3, 4 will be auto populated) e. ITC accumulated due to inverted tax structure (clause (ii) of proviso to section 54(3) f. On account of supplies made to SEZ unit/ SEZ Developer or Recipient of Deemed Exports (Select the type of supplier/ recipient) 1. Supplies to SEZ Unit 2. Supplies to SEZ Developer g. 3. Recipient of Deemed Exports Refund of accumulated ITC on account of supplies made to....

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....y that in respect of the refund amounting to Rs. ---/ with respect to the tax, interest, or any other amount for the period from---to----, claimed in the refund application, the incidence of such tax and interest has not been passed on to any other person. (This Declaration is not required to be furnished by applicants, who are claiming refund under clause (a) or clause (b) or clause (c) or clause (d) or clause (f) of sub-section (8) of section 54..) 10. Verification I/We hereby solemnly affirm and declare that the information given herein above is true and correct to the best of my/our knowledge and belief and nothing has been concealed therefrom. We declare that no refund on this account has been received by us earlier. 12 12 Place Date S....

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....ping bill/ Bill of export Integrated Tax EGM Details BRC/FIRC No. Date Value Goods/ Services HSN/ SAC UQC QTY No. Date Port Code Rate Taxable Amt. Ref No. Date No. Date value (G/S) 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 6A. Exports Note 1. Shipping Bill and EGM are mandatory; - in case of goods. 2. BRC/FIRC details are mandatory- in case of Services 15 Statement 4 Supplies to SEZ/SEZ developer Refund Type: On account of supplies made to SEZ unit/ SEZ Developer (GSTR-1: Table 6B and Table 9) GSTIN of recipient Invoice details Shipping bill/ Bill of export Integrated Tax Amended Value (Integrated Tax) (If Any) Debit Note Integrated Tax / Amended No. Date Value No Date Rate 1 2 3 4 5 6 7 Taxable Amt. Value 8 Amt. (If any) Amt. Credit Not....

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....ansaction UIN earlier Transaction which were held inter State / intra-State supply subsequently Name Invoice details Integrated Central (in case B2C) Tax Tax State/ UT Cess Place of Supply Tax Integrated Central State/ UT Cess Place of Supply (only if different from the location Tax Tax Tax (only if different from the location No. Date Value Taxable Amt Amt Amt Amtof recipient) Amt Amt Amt Amt of recipient) Value 18 1 2 3 4 5 फा 6 7 8 9 10 11 12 13 14 15 Refund Type: Excess payment of tax, if any in case of Last Return filed. Refund on account excess payment of tax (In case of taxpayer who filed last return GSTR-3 - table 12) Statement 7: Sr. No. Tax period Reference no. of return Date of filing return Tax Payable Integrated Tax C....