THE PUDUCHERRY GOODS AND SERVICES TAX FORMS 2017
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Body

FORM GST RFD-01 W

[Refer rule 90(5)]

Application for Withdrawal of Refund Application

1.	ARN	:
2.	GSTIN	:
3.	Name of Business (Legal)	:
4.	Trade Name, if any	:
5.	Tax Period	:
6.	Amount of Refund Claimed	:
7.	Grounds for Withdrawing Refund Claim :
(i)	Filed the refund application by mistake
(ii)	Filed Refund Application under wrong category
(iii)	Wrong details mentioned in the refund application
(iv)	Others (Please specify)

8. Declaration: I/We <:Taxpayer Name> hereby solemnly affirm and declare that the information given herein is true and correct to the best of my/our knowledge and belief, and nothing has been concealed therefrom.

Place:	Signature of Authorised Signatory

Date:	Name
	Designation/Status