Form A-IX

Application for provisional refund under section 69 of the Bihar Value Added Tax Act, 2005

[See rule 44(1)]

Office of the ........................................ of Commercial Taxes...................................... Circle

To

The ______________________________.

_________________________________ Circle

I, _____________________ (full name) son of _________________________________ (full name) hereby apply for provisional refund of tax in excess of my liability paid by me. The particulars are detailed below:-

DECLARATION

I ________________________, the petitioner do hereby declare that what is stated herein true to best of my knowledge and belief and that no application for refund of the above amount has been made by me or on my behalf this date.

I undertake to deposit the provisional amount received by me as and when required and it is also hereby agreed that in the event of failure of the above bounden to deposit the amount provisionally received the authorities are to cash the security deposited by me.