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THE KERALA VALUE ADDED TAX RULES, 2005 - Forms
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THE KERALA VALUE ADDED TAX RULES, 2005

FORM No. 21 CC

APPLICATION For claiming refund of input tax remaining unadjusted at the end of the year

(See Rule 47 A)

TIN                  
C.S.T                  

To

The Assessing Authority

I/We ................................. (give full address) hereby apply for refund of Rs..................... (in words........................) being amount of excess input tax remaining unadjusted as on 31st March, ................ (specify year) with reference to the Annual Return in Form No. 10 filed for the year ended 31st March, .............. (specify year) as detailed below month wise details to be attached in Annexure A.

(a) Tax Credit.  
(i) Total input tax paid during the year Rs
(ii) Special Rebate Rs
(iii) Input tax Credit on capital goods Rs
(iv) Input tax Credit on sales return Rs
(v) Others(Specify) Rs
(vi) Tax if any paid along with returns* Rs
Total (i+ii+iii+iv+v+vi) Rs
Less  
(b) Tax dues  
(i) Total out put tax due Rs
(ii) Purchase tax U/s.6(2) Rs
(iii) Reverse tax Rs
(iv) Input tax on purchase return Rs
(v) Others (Specify) Rs
Total (i+ii+iii+iv+v) Rs
Balance amount eligible for refund [(a)-(b)]  

DECLARATION

Certified that the particulars furnished herein are true and correct in all respects, that no refund had been claimed previously in respect of the same claim, that no refund adjustment had been availed of previously in respect of the same claim, that goods forming subject matter of refund claim have not suffered sales return and that no dues are outstanding against us under the Kerala Value Added Tax Act, the Kerala General Sales Tax Act, the Central Sales Tax Act or the Kerala Tax on Entry of Goods into Local Areas Act.

Place: (Seal) Signature
Date: Name & Status of the Signatory.

Month wise details to be enclosed in the annexure.

* Details of payment to be enclosed.

ANNEXURE

(a) Tax Credit

Month Total input tax paid Special Rebate ITC on Capital Goods Tax on sales return

 Advance tax paid Others

 Tax if any paid along with returns Total
1 2 3 4 5 6 7 8 9
                 
Total                

(b) Tax dues

Month

 Total output tax Due Purchase tax paid u/s 6(2) Reverse tax Tax on Purchase return Others Total Remarks
1 2 3 4 5 6 7 8
               
Total              

Place: (Seal) Signature
Date: Name & Status of the Signatory.