Bihar Value Added Tax Rules, 2005 FORMS
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Form A-V

Application for refund of amount forfeited under section 44 of the Bihar Value Added Tax Act, 2005

[See rule 31(3)]

Office of the ________________________ of Commercial Taxes ________________ Circle

To,

The______________________

____________________ circle.

I __________________________ (full name) son of ____________________ (full name) hereby apply for the refund of the amount forfeited under section 44 of the Bihar Value Added Tax Act, 2005 and furnish the following particular for that purpose -

1.	Name and style and complete address of the person/firm from whom tax was collected in contravention of sub-sections (1) and (2) of section 43-
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2.	Taxpayer Identification Number, if any, of the firm mentioned at serial number (1) above-	.......................................................................................
3.	Name and style and complete address of the firm collecting the tax in contravention of sub-sections (1) and (2) of section 43-
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4.	Taxpayer Identification Number of the firm mentioned at serial number (3) above-	.......................................................................................
5.	Number and date of invoice/invoices vide which the tax was collected in contravention of sub-sections (1) and (2) of section 43-
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6.	Value of goods, tax charged thereon and full value of the invoice/invoices mentioned at serial number (5) above
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	(Attach copy)-

DECLARATION

I do hereby declare that the above particulars are correct and complete to the best of my knowledge and belief.

Place _____________________	Signature of the Applicant ____________________
Date ______________________	Status / Designation _________________________