TMI BlogApplication for Refund (Manual) - [See rules 89(1) and 97A]X X X X Extracts X X X X X X X X Extracts X X X X ..... 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) ITC accumulated due to inverted tax structure [under clause (ii) of first proviso to section 54(3)] (e) On account of supplies made to SEZ unit/ SEZ developer (with payment of tax) (f) On account of supplies made to SEZ unit/ SEZ developer (without payment of tax) (g) Recipient of deemed export supplies/ Supplier of deemed export supplies (h) On account of order Sl. No. Type of order Order No. Order date Order Issuing Authority Payment reference no., if any ..... X X X X Extracts X X X X X X X X Extracts X X X X ..... 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 recipient shall not claim any refund with respect of the said supplies and also, the recipient has not availed any input tax credit on such supplies. Signature Name Designation / Status UNDERTAKING I hereby undertake to pay back to the Government the amount of refund sanctioned along with interest in case it is found subsequently that the requirements of clause (c) of sub-section (2) of section 16 read with sub-section (2) of section 42 of the CGST/SGST Act have not been complied with in respect of the amount refunded. Signature Name Designation / Status SELF- DECLARATION [rule 89(2)(l)] I/We ____________________ (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 refun ..... X X X X Extracts X X X X X X X X Extracts X X X X ..... y 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 * In case of imports or supplies received under reverse charge mechanism [sub-section (3) of section 9 of the CGST Act/ SGST Act or sub-section (3) of section 5 of IGST Act], the GSTIN of supplier will mean GSTIN of applicant (recipient). Statement- 2 [rule 89(2)(c)] Refund Type: Exports of services with payment of tax (Amount in Rs.) Sr. No. Invoice details Integrated tax Cess BRC/ FIRC Integrated tax and cess involved in debit note, if any Integrated tax and cess involved in credit note, if any Net Integrated tax and cess (6+7+10 - 11) No. Date Value Taxable value ..... X X X X Extracts X X X X X X X X Extracts X X X X ..... No . Date Taxable Value Amt. 1 2 3 4 5 6 7 8 9 10 11 12 Statement-5A [rule 89(4)] Refund Type: On account of supplies made to SEZ unit / SEZ developer 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 9 [ Statement 5B [rule 89(2)(g)] Refund Type: On account of deemed exports (Amount in Rs) Sl. No. Details of invoices/credit notes/debit notes of outward supplies in case refund is claimed by su ..... X X X X Extracts X X X X X X X X Extracts X X X X ..... of filing return Tax Paid in Excess Integrated tax Central tax State/ UT tax Cess 1 2 3 4 5 6 7 ] ******************** Notes-: 1. Inserted vide notification no. 55/2017 dated 15-11-2017 2. Substituted vide Notification No. 70/2017 Dated 21-12-2017 , before it was read as, Recipient of deemed export 3. Inserted vied Notification No. 70/2017 Dated 21-12-2017 4. Inserted vide Notification No. 3/2018 Dated 23-01-2018 5. Inserted vide Notification No. 3/2018 Dated 23-01-2018 6. Substituted vide Notification No.12/2018 - Dated 07-03-2018, before it was read as, DECLARATION [second proviso to section 54(3) ..... X X X X Extracts X X X X X X X X Extracts X X X X ..... EZ developer (without payment of tax) (g) 2 [Recipient of deemed export supplies/Supplier of deemed export supplies] 6 [DECLARATION [second proviso to section 54(3)] I hereby declare that the goods exported are not subject to any export duty. I also declare that I have not availed any drawback of central excise duty/service tax/central tax on goods or services or both and that I have not claimed refund of the integrated tax paid on supplies in respect of which refund is claimed. Signature Name Designation / Status]. DECLARATION [section 54(3)(ii)] I hereby declare that the refund of ITC 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, covere ..... X X X X Extracts X X X X X X X X Extracts X X X X ..... 8. 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. I/We declare that no refund on this account has been received by me/us earlier. Place Date Signature of Authorised Signatory (Name) Designation/ Status Annexure-1 Statement -1 [rule 89(5)] 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 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 3 [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 in ..... X X X X Extracts X X X X X X X X Extracts X X X X ..... Date 1 2 3 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 5 [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/ Endorsed invoice by SEZ Integrated Tax Cess Integrated tax and cess ..... X X X X Extracts X X X X X X X X Extracts X X X X
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