ORIGINAL

FORM 40

[See rule 49(1)]

Refund Adjustment Order

Under rupees____________(in words)

To,

The Treasury/ Sub-Treasury Officer,

______________

1. A Refund of Rs. _______ (In Words______________________ ) is sanctioned under section 37 of the Madhya Pradesh Vat Act, 2002 in favour of Shri / M/s _________________________ holding TIN.__________ on account of .................................................................................................

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

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

4. The amount of refund is adjusted towards the amount of Rs.___________ due to the dealer or M/s ................. Holding TIN ............................... on account of _____________ pertaining to the period from _________ to ___________ .

5. Please therefore, debit the said sum of Rs._____________ (in words_________ __________ ) to the head ______________ and credit the said sum to the head______________________ .

_______________________________________________________________________________________

Copy forwarded to M/S_________________ __________________________

______________________________________________________________________________________

(For use in the treasury / sub-Treasury)

(To be returned by treasury/sub-treasury officer to the issuing officer of adjustment order)

To

The Commercial Tax Officer/

Assistant Commissioner of Commercial Tax

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

In pursuance of your refund adjustment order no. ___________ dated _________ the sum of Rs.___________ (in words ____________ ) has been adjusted in the manner indicated therein on ____________

DUPLICATE

FORM 40

[See rule 49(1)]

Refund Adjustment Order

Under rupees____________(in words)

To,

The Treasury/ Sub-Treasury Officer,

______________

1. A Refund of Rs. _______ (In Words______________________ ) is sanctioned under section 37 of the Madhya Pradesh Vat Act, 2002 in favour of Shri / M/s _________________________ holding TIN.__________ on account of .................................................................................

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

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

4. The amount of refund is adjusted towards the amount of Rs.___________ due to the dealer on account of _____________ pertaining to the period from _________ to ___________ .

5. Please therefore, debit the said sum of Rs._____________ (in words_________ __________ ) to the head ______________ and credit the said sum to the head______________________ .

______________________________________________________________________________

Copy forwarded to M/S_________________ __________________________

______________________________________________________________________________

(For use in the treasury / sub-Treasury)

(To be returned by treasury/sub-treasury officer to the issuing officer of adjustment order)

To

The Commercial Tax Officer/

Assistant Commissioner of Commercial Tax

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

In pursuance of your refund adjustment order no. ___________ dated _________ the sum of Rs.___________ (in words ____________ ) has been adjusted in the manner indicated therein on ____________

TRIPLICATE

FORM 40

[See rule 49(1)]

Refund Adjustment Order

Under rupees____________(in words)

To,

The Treasury/ Sub-Treasury Officer,

______________

1. A Refund of Rs. _______ (In Words______________________ ) is sanctioned under section 37 of the Madhya Pradesh Vat Act, 2002 in favour of Shri / M/s _________________________ holding TIN.__________ on account of ...................................................................................

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

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

4. The amount of refund is adjusted towards the amount of Rs.___________ due to the dealer on account of _____________ pertaining to the period from _________ to ___________ .

5. Please therefore, debit the said sum of Rs._____________ (in words_________ __________ ) to the head ______________ and credit the said sum to the head______________________ .

_________________________________________________________________________________________

Copy forwarded to M/S_________________ __________________________

_________________________________________________________________________________________

(For use in the treasury / sub-Treasury)

(To be returned by treasury/sub-treasury officer to the issuing officer of adjustment order)

To

The Commercial Tax Officer/

Assistant Commissioner of Commercial Tax

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

In pursuance of your refund adjustment order no. ___________ dated _________ the sum of Rs.___________ (in words ____________ ) has been adjusted in the manner indicated therein on ____________