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Application for Refund

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..... SEZ unit/ SEZ developer (without payment of tax) (h) Recipient of deemed export supplies/ Supplier of deemed export supplies (i) Tax paid on a supply which is not provided, either wholly or partially, and for which invoice has not been issued (tax paid on advance payment) (j) Tax paid on an intra-State supply which is subsequently held to be inter-State supply and vice versa(change of POS) (k) Excess payment of tax, if any (l) Any other (specify) 8. Details of Bank account Name of bank Address of branch IFSC Type of account Account No. 9. Whether Self-Declaration filed by Applicant u/s 54(4), if applicable __Yes __No [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 input tax credit claimed in the application does not include ITC availed on .....

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..... ture 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.) 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. 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 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 rec .....

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..... f 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/ Services (G/S) Shipping bill/ Bill of export/ Endorsed invoice no. Type of Document No. Date Value No. Date 1 2 3 4 5 6 7 8 ] 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 16[Statement 5B [rule 89(2)(g)] Refund Type: On account of deemed exports claimed by supplier Sl. No. Document details of inward supplies in case refund is claimed by Supplier Tax paid Type of Document No. Date Taxable Value Integrated Tax Central Tax State/Union Territory Tax Cess 1 2 3 4 5 .....

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..... ount Date of sanction (1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) Post export price increase supplementary invoices/ debit note & IGST payment details Additional export remittance details No . Date Total value of supplementary invoice Paid in FORM GSTR-3B return period Total additional IGST paid Interest paid on IGST amount BRC/ FIRC No. Date Additional remittance amount (12) (13) (14) (15) (16) (17) (18) (19) (20) Statement 9B [rule 89(2)(bc)] Refund Type: Details of debit/ credit notes/ supplementary invoice issued for export of goods S. N o. Type of document (Debit Note/ Credit Note/ supplementary invoice) Debit Note/ Credit Note/ supplementary invoice Date of document Document Declared in GSTR-1 for the month Tax liability paid/ ITC claimed in respect of document declared in GSTR-3B for the month (1) (2) (3) (4) (5) BRC/ foreign inward remittance certificate No. Date of BRC/ foreign inward remittance certificate Whether refund claimed for shipping bill under Rule 96 (Y/N) Details of such shipping Bill No. Date of such shipping bill Port of export code (6) (7) (8) (9) (10) (11) ] Annexure-2 .....

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..... n 24[GSTR-1 as amended by GSTR-1A, if any]. 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. Invoice details Integrated tax BRC/ FIRC Integrated tax involved in debit note, if any Integrated tax involved in credit note, if any Net Integrated tax (6+9 - 10) No. Date Value Taxable value Amt. No. Date 1 .....

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..... tax collector, unregistered person 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 To 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) On account of order Sr. No. Type of order Order no. Order date Order Issuing Authority Payment reference no., if any (i) Assessment (ii) Provisional assessment (iii) Appeal (iv) Any other order (specify) (e) ITC accumulated due to inverted tax structure [clause (ii) of first proviso to section 54(3)] (f) On account of supplies made to SEZ unit/ SEZ developer (with payment of tax) (g) On account of supplies made to SEZ unit/ SEZ developer (without payment of tax) (h) 3[Recipient of deemed export supplies/Supplier of deemed export supplies] (i) Tax paid on a supply which is not provided, .....

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..... he 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 ____________________ (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.) 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. I/We declare that no refun .....

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..... any Integrated tax and cess involved in credit note, if any Net Integrated tax and cess (8+9+10-11) No. Date Value No. Date Taxable Value Amt. 1 2 3 4 5 6 7 8 9 10 11 12 ] Statement-5 [rule 89(2)(d) and 89(2)(e)] Refund Type:On account of supplies made to SEZ unit or SEZ Developer (without payment of tax) (Amount in Rs.) Sr. No. Invoice details Goods/ Services (G/S) Shipping bill/ Bill of export/ Endorsed invoice no. No. Date Value No. Date 1 2 3 4 5 6 7 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 4[Statement 5B [rule 89(2)(g)] Refund Type: On account of deemed exports (Amount in Rs) Sl. No. Details of invoices of outward supplies in case refund is claimed by supplier/ Details of invoices of inward supplies in case refund is claimed by recipient Tax paid No. Date Taxable Value Integrated Tax Central Tax State /Union Territory Tax Cess 1 .....

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..... 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 shall be filed in cases wherever required. 8. 'Net input tax credit' means input tax credit availed on inputs during the relevant period for the purpose of Statement-1 and will include ITC on input services also for the purpose of Statement-3A and 5A. 9. 'Adjusted total turnover' means the turnover in a State or a Union territory, as defined under clause (112) of section 2 excluding the value of exempt supplies other than zero-rated supplies, during the relevant period. 10. For the purpose of Statement-1, refund claim will be based on supplies reported in GSTR1 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 exp .....

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..... quot; 11. Substituted vide Notification No. 56/2019 - Central Tax dated 14-11-2019 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. 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 Amt. No. Date 1 2 3 4 5 6 7 8 9 10 11 12 " 12. Substituted vide Notification No. 56/2019 - Central Tax dated 14-11-2019 before it was read as "Statement- 3 [rule 89(2)(b) and 89(2)(c)] Refund Type: Export without payment of tax (accumulated ITC) (Amount in Rs.) 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 D .....

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