FORM 46

[See rule 46(3)]

Application for refund of the unauthorisedly collected amount forfeited under section 37 of the Chhattisgarh Value Added Tax Act, 2005

To,

The Commercial Tax Officer,

..................................Circle.

I,.........(Name of the person).......(address) hereby make an application for refund of a sum of Rs....... unauthorisedly collected from me by..........(Name of the dealer)..........(address) and forfeited by you under sub-section (3) of section 37 of the Chhattisgarh Value Added Tax Act, 2005.

The amount of Rs........ the refund of which is being claimed by me was collected from me by way of tax in respect of the goods..............(description of goods) purchased by me from the aforesaid seller and in support of my claim, I hereby enclose a copy of bill/cash memo No.............dated....... for Rs............issued by the said dealer in respect of the purchase of the aforesaid goods.