GST - APPLICATION FOR REFUND [MANUAL]

FORM-GST-RFD-01 A

                                                                                              [See rules 89(1) and 97A]

                                                                                          Application for Refund (Manual)

(Applicable for casual taxable person or non-resident taxable person, tax deductor, tax collector and other registered taxable person)

1.	GSTIN / Temporary
	ID
2.	Legal Name
3.	Trade Name, if any
4.	Address
5.	Tax period (if applicable)	From <Year><Month>          To           <Year><Month>
6.	Amount of Refund Claimed(Rs.)	Act		Tax	Interest	Penalty	Fees	Others	Total
		Central tax
		State / 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)	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

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 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, covered under this refund claim.  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 refund application, the incidence of such tax and interest has not been passed on to any other person.  Signature  Name – Designation / Status  (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.)

 

8. Verification I/We<Taxpayer Name> 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      Signature of Authorised Signatory Date        (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	Tax payable on	Adjusted	Net input tax	Maximum refund
inverted rated	such inverted	total turnover	credit	amount to be claimed
supply of goods	rated supply of  goods			[(1×4÷3)-2]
1	2	3	4	5

  

                                               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	Net input tax credit	Adjusted total	Refund amount
supply of goods and services		turnover	(1×2÷3)
1	2	3	4

  

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	Net input tax credit	Adjusted total	Refund amount
supply of goods and services		turnover	(1×2÷3)
1	2	3	4