Form VAT-XXIX

(See rule 5(1) of the Goa Value Added Tax Rules, 2005)

Application for claim for reimbursement of tax paid on purchases made by specialized agencies of UNO, etc. under sub-section (1) of Section 6 of the Goa Value Added Tax Act, 2005. (Act 9 of 2005)

To,

The Commissioner of Commercial Taxes,

Government of Goa,

Panaji Goa.

Sir,

I.................................(name and designation of the officer signing the application) of the ......................................, do hereby apply for reimbursement of tax collected on the purchases of goods made by me/us specified in the invoice/cash memo no................dated..............of Shri/M/s ............................................................................who is/are registered dealer under the Goa Value Added Tax Act, 2005. (Act 9 of 2005)

My/our Bank Account in India is under no...............and the payment towards such reimbursement of tax be made payable by demand draft to be credited to the said Bank Account.

Invoice/Cash Memo relating to the said purchases is enclosed in original.

Enclosed: invoice/cash memo

(in original)