MADHYA PRADESH VALUE ADDED TAX RULES, 2006 - FORMS
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Body

FORM 40-A

(See Rule 53)

Application for provisional refund under section 37-A of the Madhya Pradesh Vat Act, 2002

To,

.................................

I, being eligible to claim refund of unadjusted input tax rebate under clause (ii) of subsection (4) of section 14 of the Madhya Pradesh Vat Act, 2002, make an application for grant of provisional refund under sub-section (1) of section 37-A of the said Act. Particulars are given below:-

			TIN	2 3
Period	DD	MM	YYYY	To	DD	MM	YYYY

Name and address of the Dealer

(Affix seal)

1. Gross Turnover (GTO)

2. Deductions

3. Taxable Turnover (1-2)

4. Vat

5. Purchase tax

5A. Amount payable u/s 9-C

5B. Amount payable u/s 26-A (5)

6. Reversal of Input Tax Rebate

7. Interest for Late Payment (if any)

8. Amount of tax deferred / exempted

9. Total amount payable (4+5+5A+5B+6+7-8)

10. Input Tax Rebate

11. Input Tax Rebate carried forward from previous year

12. Other credits (TDS, RAO etc.)

13. Amount paid by challans

14. Input Tax Rebate carried over to next year

15. Unadjusted Input Tax Rebate claimed as refund

Declaration

I............................................. (Name) being.......................................... of the above business firm do hereby

declare that the information and particulars given above are true and correct to the best of my knowledge and belief, and are based on the returns submitted and the books of account.

Place
Date ..........................	Signature of the Dealer

Note : This form shall be signed by any person as prescribed in sub-rule (1) of rule 11 of Madhya Pradesh Vat Rules, 2006.

ACKNOWLEDGMENT

Form 40-A Receipt Number:.................. Date: / /

			TIN	2 3
Period	DD	MM	YYYY	To	DD	MM	YYYY

Name of the Dealer and address

(Affix seal)

Circle office

Signature of Receiving Official (Employee id:...........)