Application for Refund

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....ut payment of Tax, i.e., ITC accumulated 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....

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....ation/Status I/We SELF-DECLARATION (Applicant) having GSTIN/ temporary Id -------- solemnly affirm and certify 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 ....

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....ed Tax = (11/8)+12-13 1 2 3 4 5 6 7 8 9 10 11 12 13 14 6A. Exports BRC/FIRC details are mandatory- in case of services 14 Refund Type: Export without payment of Tax-Accumulated ITC (GSTR-1: Table 6A) Statement-3 GSTIN of recipient Invoice details Shipping 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 accoun....

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.... Integra Cent Stat CE te ue ted tax ral e/ SS Tax UT Tax ry)/ Ineligibl ral Tax e/ SS Any) (If any) (If any) e for ITC UT Tax اني + 5 = 13 1294967891028 14 15 16 17 18 19 20 17 Statement 6: Refund Type: Tax paid on an intra-State supply which is subsequently held to be inter-State supply and vice versa Order Details (issued in pursuance of Section 77 (1) and (2), if any: Order No: Order Date: GSTIN/ Details of invoice covering transaction considered as intra-State / inter-State transaction 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 ....