[See rule 48(1)(a)]

Refund payment order

Counter foil

(under Rs.________________)

Book No.___Voucher .No..........

To,

The Treasury /Sub-Treasury Officer .......................................

1. A refund of Rs..................... (in words) Rs ..................... ............................................ has been sanctioned in favour of Shri/ M/s. ............................ .......................................... under section 37 of the Madhya Pradesh Vat Act, 2002 on account of ........................... ..........................................

2. No refund of the amount mentioned above has previously been granted.

3. Entry of the order of refund has been duly made in the relevant record pertaining to the said dealer under my signature.

4. Please pay to Shri / M/s.......................................... ................................. the sum of Rs........................ (in figures) Rupees.................. ...............................(in words) only of transfer the amount to his bank A/C No. .................... IFS code ...................... of .................. Name and address of the Bank Branch) and debit to the head ......... .............................................

Place ..............

Date............

signature & Designation

[See rule 48(1)(a)]

Refund payment order

(for use in treasury only)

(Payable at Government treasury / sub-treasury within 3 months from the date of issue )

(under Rs.________________)

Book No.___Voucher .No..........

To,

The Treasury /Sub-Treasury Officer .......................................

1. A refund of Rs..................... (in words) Rs ..................... ............................................ has been sanctioned in favour of Shri/ M/s. ............................ .......................................... under section 37 of the Madhya Pradesh Vat Act, 2002 on account of ........................... ..........................................

2. No refund of the amount mentioned above has previously been granted.

3. Entry of the order of refund has been duly made in the relevant record pertaining to the said dealer under my signature.

4. Please pay to Shri / M/s.......................................... ................................. the sum of Rs........................ (in figures) Rupees.................. ...............................(in words) only of transfer the amount to his bank A/C No. .................... IFS code ...................... of .................. Name and address of the Bank Branch) and debit to the head ....... ............................................

Place ..............

Date............

signature & Designation

[See rule 48(1)(a)]

Refund payment order

(To be submitted in treasury by the claimant)

(Payable at Government treasury / sub-treasury within 3 months from the date of issue )

(under Rs.________________)

Book No.___Voucher .No..........

To,

The Treasury /Sub-Treasury Officer .......................................

1. A refund of Rs..................... (in words) Rs ..................... ............................................ has been sanctioned in favour of Shri/ M/s. ............................ .......................................... under section 37 of the Madhya Pradesh Vat Act, 2002 on account of ........................... ..........................................

2. No refund of the amount mentioned above has previously been granted.

3. Entry of the order of refund has been duly made in the relevant record pertaining to the said dealer under my signature.

4. Please pay to Shri / M/s.......................................... ................................. the sum of Rs........................ (in figures) Rupees.................. ...............................(in words) only of transfer the amount to his bank A/C No. .................... IFS code ...................... of .................. Name and address of the Bank Branch) and debit to the head ........ .............................................

Place ..............

Date............

signature &Designation

Pay Rs.............................only

Date..............

Treasury Officer/ sub-treasury officer

Pay Rs.............................only

Date..............

Treasury Officer/ sub-treasury officer

claimants signature

claimants signature