THE RAJASTHAN VALUE ADDED TAX RULES, 2006 - FORMS
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Body

Form VAT - 21

[See Rule 27(1)(c)&(2)]

Application for Refund by Exporters

Registration No. (TIN)

Name of Dealer

2. Address

Bldg. No/ Name/ Area

Town/City

District (State)

Pin Code

e-mail Id

Telephone Number(s)

Fax No.

Alternate e.mail Id

3. Details of Bank:

3.1 Name of the Bank in which refund is sought

3.2 Name of the Branch

3.3 Account No.

3.4 Account Type

3.5 IFSC No. of Branch

3.6 Whether the Branch has CBS arrangement

Yes

4. Type of export

Under Section 5(1) of the CST Act, 1956

Under Section 5(3) of the CST Act, 1956

5. Period for which refund is claimed :

From

6. Amount of Refund claimed (Rs.)

___________________________________________________

7. Details of purchases of goods for which refund is claimed :

S. No.

Goods purchased from

Reg. No. (TIN)

VAT invoice no.

Date

Description of goods

Quantity

Value

(Rs. )

Tax paid

(Rs.)

8. Details of the sale deemed in the course of export u/s 5(1):

S. No.

VAT invoice No.

Date

Goods Exported to (Name of the country)

Description of goods

Quantity

Value

Rs.

Give Details as per rule 28(2)(b)

9. Details of the sale deemed in the course of export u/s 5(3):

S. No.

VAT invoice No.

Date

Goods sold to

Reg. No. (TIN)

Description of goods

Quantity

Value

Rs.

Give Details as per rule 28(2)(b)

Declaration

I declare that I have not taken credit of input tax on purchases for which I have claimed refund and that I have reversed credit of input tax, claimed earlier

Place :		Signature
Date :		Name :
		Status :

Undertaking

I ...............................................................S/o ......................................................................... resident of ................................. (Status) ........................ of M/s ............................. ............................................... do hereby solemnly affirm on oath that, in case of re-import of the above goods, I will communicate within a period of one month from the date of re-import into India of such goods, to the assessing authority or any other officer authorized by the Commissioner in this behalf and shall repay, forthwith, the amount of refund granted to me on this account along with interest.

Deponent

Verification

I verify that the above information and its enclosures (if any) are true and correct to the best of my knowledge and belief and nothing has been concealed

Place :		Signature
Date :
	Name :
	Status :

Instructions:

1. Please read the instructions carefully

2. All the entries should be filled in capital letters

3. "Tick" applicable in option boxes

4. The application should be filed in duplicate

5. Enclose the following :

a. Attested copy of declaration form VAT-15 or Form H in case of exports u/s 5(3) of CST Act

b. Certified copy of air consignment note / bill of lading / railway receipt or goods vehicle or postal receipt or any other documents in proof of export of goods across the customs frontier of India; duly authenticated by Customs Department

c. Duplicate copy of Sale Invoice

d. Certified copy(ies) of purchase invoice on the basis of which refund of ITC is claimed

e. Undertaking in prescribed form

f. Certificate from a Chartered Accountant regarding purchase and sale of goods and correctness of claim of refund (in Form VAT-26).

6. This Form should be verified and signed by:

a. Proprietor, in case of Proprietorship concern

b. Managing Partner, in case of Partnership firm and where there is no Managing Partner, by all the partners if there is no registered partnership deed and in case of a registered partnership deed by any one of them.

c. Managing Director or authorized signatory, in case of a Company

d. Karta, in case of Hindu Undivided Family

e. Authorised Signatory, in all other cases

f. Or by the declared Business Manager