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Application for Refund

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..... Cess Total 7. Grounds of refund claim (select from drop down) (a) Excess balance in Electronic Cash Ledger (b) Exports of services- with payment of tax (c) Exports of goods / services- without payment of tax (accumulated ITC) (d) On account of order Sr. No. Type of order Order no. Order date Order Issuing Authority Payment reference no., if any (i) Assessment (ii) Finalization of Provisional assessment .....

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..... tax credit claimed in the application does not include ITC availed on goods or services used for making nil rated or fully exempt supplies. Signature Name Designation / Status 8 [DECLARATION [rule 89(2)(f)] I hereby declare that tax has not been collected from the Special Economic Zone unit /the Special Economic Zone developer in respect of supply of goods or services or both covered under this refund claim. Signature Name Designation / Status ] DECLARATION [rule 89(2)(g)] (For recipient/supplier of deemed export) In case refund claimed by recipient__ I hereby declare that the refund has been claimed only for those invoices which have been detailed in statement 5B for the tax period for which refund is being claimed and the amount does not exceed the amount of input tax credit availed in the valid return filed for the said tax period. I also declare that the supplier has not claimed refund with respect to the said supplies. In case refund claimed by supplier__ I hereby declare that the refund has been claimed only for .....

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..... Refund Type: ITC accumulated due to inverted tax structure [clause (ii) of first proviso to section 54(3)] (Amount in Rs.) Turnover of inverted rated supply of goods and services Tax payable on such inverted rated supply of goods and services Adjusted total turnover Net input tax credit Maximum refund amount to be claimed [(1 4 3)-2] 1 2 3 4 5 10 [ Statement 1A [rule 89(2)(h)] Refund Type: ITC accumulated due to inverted tax structure [clause (ii) of first proviso to section 54(3)] Sl. No. Details of documents of inward supplies received of inputs received Tax paid on Inward supplies Type of Inward supply GSTIN of Supplier/Self GSTIN Type of Document No./B/E Port Code Date Taxable Value Integrated Tax Cent .....

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..... . Document Details Goods / Services (G/S) Type of Document No. Date Value 1 2 3 4 5 6 Shipping bill/ Bill of export EGM Details BRC/ FIRC Port code No Date 20 [ FOB value Ref No Date No. Date Value 7 8 9 9A ] 10 11 12 13 14 ] Statement- 3A [rule 89(4)] Refund Type: Export without payment of tax (accumulated ITC) calculation of refund amount (Amount in Rs.) .....

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..... ] 14 [ Statement 4A Refund by SEZ on account of supplies received from DTA With payment of tax GSTIN of Supplier Document Details Shipping bill/ Bill of export/ Endorsed invoice by SEZ Taxable Value Integrated Tax Cess Type of Document No. Date Value No. Date 1 2 3 4 5 6 7 8 9 10 ] 15 [ Statement 5 [rule 89(2)(d) and rule 89(2)(e)] Refund Type: On account of supplies made to SEZ unit or SEZ Developer (without payment of tax) Sr. No. Document Details Goods/ Servi .....

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..... Date Taxable Value Integrated Tax Central Tax State/Uni on Territory Tax Cess 1 2 3 4 5 6 7 8 9 10 ] 17 [ Statement 6 [rule 89(2)(j)] Refund Type: On account of change in POS (inter-state to intra-state and vice versa) Document Type B2C/Registered Recipeint GSTIN/UIN Name (in case of B2C) Document Details Type of Document No. Date Value Taxable Value 1 2 3 4 5 6 7 8 .....

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..... Sl. No. GSTIN of supplier Document/ Invoice Details Tax Paid Details of payment of invoice value to the supplier Details of payment received against cancellation/ termination Refund Amount Claimed (I+ C+ S+ Cess) Type of document No. Date Taxable Value Integr ated Tax (I) Central Tax (C) State/ UT Tax (S) Cess Date Amount Date Amount 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 .....

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..... ies, during the relevant period. 10. For the purpose of Statement-1, refund claim will be based on supplies reported in GSTR-1 and GSTR-2. 11. BRC or FIRC details will be mandatory where refund is claimed against export of services details of shipping bill and EGM will be mandatory to be provided in case of export of goods. 12. Where the invoice details are amended (including export), refund shall be allowed as per the calculation based on amended value. 13. Details of export made without payment of tax shall be reported in Statement-3. 14. Availability of refund to be claimed in case of supplies made to SEZ unit or SEZ developer without payment of tax shall be worked out in accordance with the formula prescribed in rule 89(4). 15. Turnover of zero rated supply of goods and services shall have the same meaning as defined in rule 89(4).] ******* Notes: 1. Substituted vide not. no. 47/2017 - Dated 18-10-2017, before it was read as, Statement- 2 [rule 89(2)(c)] Refund Type: Exports of services with payment of tax (Amount in Rs.) Sr. No. .....

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..... 3. Substituted vide Notification No. 70/2017 - Dated 21-12-2017, before it was read as, Recipient of deemed export 4. Inserted vide Notification No. 70/2017 - Dated 21-12-2017, 5. Substituted vide Notification No. 70/2017 - Dated 21-12-2017, before it was read as, DECLARATION [rule 89(2)(g)] (For recipients of deemed export) I hereby declare that the refund has been claimed only for those invoices which have been reported in statement of inward supplies filed in Form GSTR-2 for the tax period for which refund is being claimed and the amount does not exceed the amount of input tax credit availed in the valid return filed for the said tax period. Signature .....

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..... tate / UT tax Integrated tax Cess Total 7. Grounds of refund claim (select from drop down) (a) Excess balance in Electronic Cash Ledger (b) Exports of services- with payment of tax (c) Exports of goods / services- without payment of tax (accumulated ITC) (d) On account of order Sr. No. Type of order Order no. Order date Order Issuing Authority Payment reference no., if any (i) .....

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..... Designation / Status] DECLARATION [section 54(3)(ii)] I hereby declare that the refund of input tax credit claimed in the application does not include ITC availed on goods or services used for making nil rated or fully exempt supplies. Signature Name Designation / Status DECLARATION [rule 89(2)(f)] I hereby declare that the Special Economic Zone unit /the Special Economic Zone developer has not availed of the input tax credit of the tax paid by the applicant, covered under this refund claim. Signature Name Designation / Status 5 [ DECLARATION [rule 89(2)(g)] (For recipient/supplier of deemed export) In case refund claimed by recipient __ I hereby declare that the refund has been claimed only for those invoices which have been detailed in statement 5B for the tax period for which refund is being claimed and the amount does not exceed the amount of input tax credit availed in the valid return filed for the said tax period. I .....

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..... accumulated due to inverted tax structure [clause (ii) of first proviso to section 54(3)] (Amount in Rs.) Turnover of inverted rated supply of goods Tax payable on such inverted rated supply of goods Adjusted total turnover Net input tax credit Maximum refund amount to be claimed [(1 4 3)-2] 1 2 3 4 5 4 [Statement 1A [rule 89(2)(h)] Refund type: ITC accumulated due to inverted tax structure [clause (ii) of first proviso to section 54(3)] Sl. No. Details of invoices of inward supplies received Tax paid on inward supplies Details of invoices of outward supplies issued Tax paid on outward supplies No. Date Taxable Value Integrated Tax Central Tax State/Un ion territory .....

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..... 4 5 6 7 8 9 10 11 12 Statement- 3A [rule 89(4)] Refund Type: Export without payment of tax (accumulated ITC) calculation of refund amount (Amount in Rs.) Turnover of zero rated supply of goods and services Net input tax credit Adjusted total turnover Refund amount (1 2 3) 1 2 3 4 2 [Statement-4 [rule 89(2)(d) and 89(2)(e)] Refund Type: On account of supplies made to SEZ unit or SEZ Developer (on payment of tax) (Amount in Rs.) GSTIN of recipient Invoice details Shipping bill/ Bill of export/ End .....

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..... No. Date Taxable Value Integrated Tax Central Tax State /Union Territory Tax Cess 1 2 3 4 5 6 7 8 ] Statement-6 [rule 89(2)(j)] Refund Type: On account of change in POS of the supplies (inter-State to intra-State and vice versa) Order Details (issued in pursuance of sections 77 (1) and (2), if any: Order No: Order Date: (Amount in Rs.) GSTIN/ UIN Name (in case B2C) Details of invoices covering transaction considered as intra State / inter-State transaction earlier Transaction which were held inter State / intra-State supply subsequently Invoice details Integrated tax Central tax State/ UT tax Cess Place of Supply .....

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..... From registered person to unregistered person (b) EGM: Export General Manifest (c) GSTIN: Goods and Services Tax Identification Number (d) IGST: Integrated goods and services tax (e) ITC: Input tax credit (f) POS: Place of Supply (Respective State) (g) SEZ: Special Economic Zone (h) Temporary ID: Temporary Identification Number (i) UIN: Unique Identity Number 2. Refund of excess amount available in electronic cash ledger can also be claimed through return or by filing application. 3. Debit entry shall be made in electronic credit or cash ledger at the time of filing the application. 4. Acknowledgement in FORM GST RFD-02 will be issued if the application is found complete in all respects. 5. Claim of refund on export of goods with payment of IGST shall not be processed through this application. 6. Bank account details should be as per registration data. Any change in bank details shall first be amended in registration particulars before quoting in the application. 7. Declaration .....

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..... Taxable Value Integrated Tax Central Tax State Tax /Union Territory Tax Cess 1 2 3 4 5 6 7 8 9 10. Substituted vide Notification No. 56/2019 Central Tax dated 14-11-2019 before it was read as Statement 1A [rule 89(2)(h)] Refund Type: ITC accumulated due to inverted tax structure [clause (ii) of first proviso to section 54(3)] Sl. No. Details of invoices of inward supplies of inputs received Tax paid on inward supplies of inputs Details of invoices of outward supplies issued Tax paid on outward supplies GST IN of the supplier * No. Date Taxable Value Integrated Tax Central Tax State Tax /Uni .....

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..... .) Sr. No. Invoice details Goods/ Services (G/S) Shipping bill/ Bill of export EGM Details BRC/ FIRC No. Date Value Port code No. Date Ref No. Date No. Date 1 2 3 4 5 6 7 8 9 10 11 12 13. Substituted vide Notification No. 56/2019 Central Tax dated 14-11-2019 before it was read as Statement-4 [rule 89(2)(d) and 89(2)(e)] Refund Type: On account of supplies made to SEZ unit or SEZ Developer (on payment of tax) (Amount in Rs.) GSTIN of recipient Invoice details S .....

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..... tral Tax State Tax /Union territory Tax Cess 1 2 3 4 5 6 7 8 9 10 ] 17. Substituted vide Notification No. 56/2019 Central Tax dated 14-11-2019 before it was read as Statement-6 [rule 89(2)(j)] Refund Type: On account of change in POS (inter-State to intra-State and vice versa) Order Details (issued in pursuance of sections 77 (1) and (2), if any: Order No: Order Date: (Amount in Rs.) Recipient s GSTIN/ UIN Name (in case B2C) Invoice details Details of tax paid on transaction considered as intra State / inter-State transaction earlier Taxes re-assessed on transaction which were held inter State / intra-State supply subsequently Integrated tax Central tax State .....

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