Sr. no.
|
Distance
|
Validity period
|
(1)
|
(2)
|
(3)
|
1.
|
Upto 100 km
|
One day
|
2.
|
For every 100 km or part thereof thereafter
|
One additional day
|
S.
No.
|
Chapter or Heading or Sub-heading or Tariff item
|
Description of Goods
|
(1)
|
(2)
|
(3)
|
1.
|
0101
|
Live asses, mules and hinnies
|
2.
|
0102
|
Live bovine animals
|
3.
|
0103
|
Live swine
|
4.
|
0104
|
Live sheep and goats
|
5.
|
0105
|
Live poultry, that is to say, fowls of the species Gallus domesticus, ducks, geese, turkeys and guinea fowls.
|
6.
|
0106
|
Other live animal such as Mammals, Birds, Insects
|
7.
|
0201
|
Meat of bovine animals, fresh and chilled.
|
8.
|
0202
|
Meat of bovine animals frozen [other than frozen and put up in unit
container]
|
9.
|
0203
|
Meat of swine, fresh, chilled or frozen [other than frozen and put up in
unit container]
|
10.
|
0204
|
Meat of sheep or goats, fresh, chilled or frozen [other than frozen and
put up in unit container]
|
11.
|
0205
|
Meat of horses, asses, mules or hinnies, fresh, chilled or frozen [other than frozen and put up in unit container]
|
12.
|
0206
|
Edible offal of bovine animals, swine, sheep, goats, horses, asses,
mules or hinnies, fresh, chilled or frozen [other than frozen and put up in unit container]
|
13.
|
0207
|
Meat and edible offal, of the poultry of heading 0105, fresh, chilled or
frozen [other than frozen and put up in unit container]
|
S.
No.
|
Chapter or Heading or Sub-heading or Tariff item
|
Description of Goods
|
(1)
|
(2)
|
(3)
|
14.
|
0208
|
Other meat and edible meat offal, fresh, chilled or frozen [other than
frozen and put up in unit container]
|
15.
|
0209
|
Pig fat, free of lean meat, and poultry fat, not rendered or otherwise extracted, fresh, chilled or frozen [other than frozen and put up in unit container]
|
16.
|
0209
|
Pig fat, free of lean meat, and poultry fat, not rendered or otherwise extracted, salted, in brine, dried or smoked [other than put up in unit
containers]
|
17.
|
0210
|
Meat and edible meat offal, salted, in brine, dried or smoked; edible flours and meals of meat or meat offal, other than put up in unit
containers
|
18.
|
3
|
Fish seeds, prawn / shrimp seeds whether or not processed, cured or in frozen state [other than goods falling under Chapter 3 and attracting
2.5%]
|
19.
|
0301
|
Live fish.
|
20.
|
0302
|
Fish, fresh or chilled, excluding fish fillets and other fish meat of
heading 0304
|
21.
|
0304
|
Fish fillets and other fish meat (whether or not minced), fresh or
chilled.
|
22.
|
0306
|
Crustaceans, whether in shell or not, live, fresh or chilled; crustaceans, in shell, cooked by steaming or by boiling in water live, fresh or chilled.
|
23.
|
0307
|
Molluscs, whether in shell or not, live, fresh, chilled; aquatic
invertebrates other than crustaceans and molluscs, live, fresh or chilled.
|
24.
|
0308
|
Aquatic invertebrates other than crustaceans and molluscs, live, fresh
or chilled.
|
25.
|
0401
|
Fresh milk and pasteurised milk, including separated milk, milk and cream, not concentrated nor containing added sugar or other
sweetening matter, excluding Ultra High Temperature (UHT) milk
|
26.
|
0403
|
Curd; Lassi; Butter milk
|
27.
|
0406
|
Chena or paneer, other than put up in unit containers and bearing a
registered brand name;
|
28.
|
0407
|
Birds' eggs, in shell, fresh, preserved or cooked
|
29.
|
0409
|
Natural honey, other than put up in unit container and bearing a registered brand name
|
30.
|
0501
|
Human hair, unworked, whether or not washed or scoured; waste of
human hair
|
31.
|
0506
|
All goods i.e. Bones and horn-cores, unworked, defatted, simply prepared (but not cut to shape), treated with acid or gelatinised; powder
and waste of these products
|
32.
|
0507 90
|
All goods i.e. Hoof meal; horn meal; hooves, claws, nails and beaks;
antlers; etc.
|
33.
|
0511
|
Semen including frozen semen
|
S.
No.
|
Chapter or Heading or Sub-heading or Tariff item
|
Description of Goods
|
(1)
|
(2)
|
(3)
|
34.
|
6
|
Live trees and other plants; bulbs, roots and the like; cut flowers and
ornamental foliage
|
35.
|
0701
|
Potatoes, fresh or chilled.
|
36.
|
0702
|
Tomatoes, fresh or chilled.
|
37.
|
0703
|
Onions, shallots, garlic, leeks and other alliaceous vegetables, fresh or
chilled.
|
38.
|
0704
|
Cabbages, cauliflowers, kohlrabi, kale and similar edible brassicas,
fresh or chilled.
|
39.
|
0705
|
Lettuce (Lactuca sativa) and chicory (Cichorium spp.), fresh or chilled.
|
40.
|
0706
|
Carrots, turnips, salad beetroot, salsify, celeriac, radishes and similar
edible roots, fresh or chilled.
|
41.
|
0707
|
Cucumbers and gherkins, fresh or chilled.
|
42.
|
0708
|
Leguminous vegetables, shelled or unshelled, fresh or chilled.
|
43.
|
0709
|
Other vegetables, fresh or chilled.
|
44.
|
0712
|
Dried vegetables, whole, cut, sliced, broken or in powder, but not
further prepared.
|
45.
|
0713
|
Dried leguminous vegetables, shelled, whether or not skinned or split.
|
46.
|
0714
|
Manioc, arrowroot, salep, Jerusalem artichokes, sweet potatoes and similar roots and tubers with high starch or inulin content, fresh or
chilled; sago pith.
|
47.
|
0801
|
Coconuts, fresh or dried, whether or not shelled or peeled
|
48.
|
0801
|
Brazil nuts, fresh, whether or not shelled or peeled
|
49.
|
0802
|
Other nuts, Other nuts, fresh such as Almonds, Hazelnuts or filberts (Coryius spp.), walnuts, Chestnuts (Castanea spp.), Pistachios, Macadamia nuts, Kola nuts (Cola spp.), Areca nuts, fresh, whether or
not shelled or peeled
|
50.
|
0803
|
Bananas, including plantains, fresh or dried
|
51.
|
0804
|
Dates, figs, pineapples, avocados, guavas, mangoes and mangosteens,
fresh.
|
52.
|
0805
|
Citrus fruit, such as Oranges, Mandarins (including tangerines and satsumas); clementines, wilkings and similar citrus hybrids, Grapefruit, including pomelos, Lemons (Citrus limon, Citrus limonum) and limes
(Citrus aurantifolia, Citrus latifolia), fresh.
|
53.
|
0806
|
Grapes, fresh
|
54.
|
0807
|
Melons (including watermelons) and papaws (papayas), fresh.
|
55.
|
0808
|
Apples, pears and quinces, fresh.
|
56.
|
0809
|
Apricots, cherries, peaches (including nectarines), plums and sloes,
fresh.
|
57.
|
0810
|
Other fruit such as strawberries, raspberries, blackberries, mulberries and loganberries, black, white or red currants and gooseberries, cranberries, bilberries and other fruits of the genus vaccinium, Kiwi fruit, Durians, Persimmons, Pomegranates, Tamarind, Sapota (chico),
Custard-apple (ata), Bore, Lichi, fresh.
|
S.
No.
|
Chapter or Heading or Sub-heading or Tariff item
|
Description of Goods
|
(1)
|
(2)
|
(3)
|
58.
|
0814
|
Peel of citrus fruit or melons (including watermelons), fresh.
|
59.
|
9
|
All goods of seed quality
|
60.
|
0901
|
Coffee beans, not roasted
|
61.
|
0902
|
Unprocessed green leaves of tea
|
62.
|
0909
|
Seeds of anise, badian, fennel, coriander, cumin or caraway; juniper
berries [of seed quality]
|
63.
|
0910 11 10
|
Fresh ginger, other than in processed form
|
64.
|
0910 30 10
|
Fresh turmeric, other than in processed form
|
65.
|
1001
|
Wheat and meslin [other than those put up in unit container and bearing a registered brand name]
|
66.
|
1002
|
Rye [other than those put up in unit container and bearing a registered
brand name]
|
67.
|
1003
|
Barley [other than those put up in unit container and bearing a
registered brand name]
|
68.
|
1004
|
Oats [other than those put up in unit container and bearing a registered
brand name]
|
69.
|
1005
|
Maize (corn) [other than those put up in unit container and bearing a
registered brand name]
|
70.
|
1006
|
Rice [other than those put up in unit container and bearing a registered
brand name]
|
71.
|
1007
|
Grain sorghum [other than those put up in unit container and bearing a
registered brand name]
|
72.
|
1008
|
Buckwheat, millet and canary seed; other cereals such as Jawar, Bajra, Ragi] [other than those put up in unit container and bearing a registered brand name]
|
73.
|
1101
|
Wheat or meslin flour [other than those put up in unit container and
bearing a registered brand name].
|
74.
|
1102
|
Cereal flours other than of wheat or meslin, [maize (corn) flour, Rye
flour, etc.] [other than those put up in unit container and bearing a registered brand name]
|
75.
|
1103
|
Cereal groats, meal and pellets [other than those put up in unit
container and bearing a registered brand name]
|
76.
|
1104
|
Cereal grains hulled
|
77.
|
1105
|
Flour, of potatoes [other than those put up in unit container and bearing
a registered brand name]
|
78.
|
1106
|
Flour, of the dried leguminous vegetables of heading 0713 (pulses) [other than guar meal 1106 10 10 and guar gum refined split 1106 10 90], of sago or of roots or tubers of heading 0714 or of the products of
Chapter 8 i.e. of tamarind, of singoda, mango flour, etc. [other than those put up in unit container and bearing a registered brand name]
|
79.
|
12
|
All goods of seed quality
|
80.
|
1201
|
Soya beans, whether or not broken, of seed quality.
|
81.
|
1202
|
Ground-nuts, not roasted or otherwise cooked, whether or not shelled
|
S.
No.
|
Chapter or Heading or Sub-heading or Tariff item
|
Description of Goods
|
(1)
|
(2)
|
(3)
|
|
|
or broken, of seed quality.
|
82.
|
1204
|
Linseed, whether or not broken, of seed quality.
|
83.
|
1205
|
Rape or colza seeds, whether or not broken, of seed quality.
|
84.
|
1206
|
Sunflower seeds, whether or not broken, of seed quality.
|
85.
|
1207
|
Other oil seeds and oleaginous fruits (i.e. Palm nuts and kernels, cotton seeds, Castor oil seeds, Sesamum seeds, Mustard seeds, Saffower (Carthamustinctorius) seeds, Melon seeds, Poppy seeds, Ajams, Mango kernel, Niger seed, Kokam) whether or not broken, of seed
quality.
|
86.
|
1209
|
Seeds, fruit and spores, of a kind used for sowing.
|
87.
|
1210
|
Hop cones, fresh.
|
88.
|
1211
|
Plants and parts of plants (including seeds and fruits), of a kind used primarily in perfumery, in pharmacy or for insecticidal, fungicidal or
similar purpose, fresh or chilled.
|
89.
|
1212
|
Locust beans, seaweeds and other algae, sugar beet and sugar cane, fresh or chilled.
|
90.
|
1213
|
Cereal straw and husks, unprepared, whether or not chopped, ground,
pressed or in the form of pellets
|
91.
|
1214
|
Swedes, mangolds, fodder roots, hay, lucerne (alfalfa), clover, sainfoin, forage kale, lupines, vetches and similar forage products,
whether or not in the form of pellets.
|
92.
|
1301
|
Lac and Shellac
|
93.
|
1404 90 40
|
Betel leaves
|
94.
|
1701 or 1702
|
Jaggery of all types including Cane Jaggery (gur) and Palmyra Jaggery
|
95.
|
1904
|
Puffed rice, commonly known as Muri, flattened or beaten rice, commonly known as Chira, parched rice, commonly known as khoi, parched paddy or rice coated with sugar or gur, commonly known as
Murki
|
96.
|
1905
|
Pappad
|
97.
|
1905
|
Bread (branded or otherwise), except pizza bread
|
98.
|
2201
|
Water [other than aerated, mineral, purified, distilled, medicinal, ionic,
battery, de-mineralized and water sold in sealed container]
|
99.
|
2201
|
Non-alcoholic Toddy, Neera including date and palm neera
|
100.
|
2202 90 90
|
Tender coconut water other than put up in unit container and bearing a
registered brand name
|
101.
|
2302, 2304,
2305, 2306,
2308, 2309
|
Aquatic feed including shrimp feed and prawn feed, poultry feed and cattle feed, including grass, hay and straw, supplement andhusk of
pulses, concentrates andadditives, wheat bran and de-oiled cake
|
102.
|
2501
|
Salt, all types
|
103.
|
2835
|
Dicalcium phosphate (DCP) of animal feed grade conforming to IS specification No.5470 : 2002
|
104.
|
3002
|
Human Blood and its components
|
105.
|
3006
|
All types of contraceptives
|
S.
No.
|
Chapter or Heading or Sub-heading or Tariff item
|
Description of Goods
|
(1)
|
(2)
|
(3)
|
106.
|
3101
|
All goods and organic manure [other than put up in unit containers and
bearing a registered brand name]
|
107.
|
3304
|
Kajal [other than kajal pencil sticks], Kumkum, Bindi, Sindur, Alta
|
108.
|
3825
|
Municipal waste, sewage sludge, clinical waste
|
109.
|
3926
|
Plastic bangles
|
110.
|
4014
|
Condoms and contraceptives
|
111.
|
4401
|
Firewood or fuel wood
|
112.
|
4402
|
Wood charcoal (including shell or nut charcoal), whether or not
agglomerated
|
113.
|
4802 / 4907
|
Judicial, Non-judicial stamp papers, Court fee stamps when sold by the Government Treasuries or Vendors authorised by the Government
|
114.
|
4817 / 4907
|
Postal items, like envelope, Post card etc., sold by Government
|
115.
|
48 / 4907
|
Rupee notes when sold to the Reserve Bank of India
|
116.
|
4907
|
Cheques, lose or in book form
|
117.
|
4901
|
Printed books, including Braille books
|
118.
|
4902
|
Newspapers, journals and periodicals, whether or not illustrated or
containing advertising material
|
119.
|
4903
|
Children's picture, drawing or colouring books
|
120.
|
4905
|
Maps and hydrographic or similar charts of all kinds, including atlases, wall maps, topographical plans and globes, printed
|
121.
|
5001
|
Silkworm laying, cocoon
|
122.
|
5002
|
Raw silk
|
123.
|
5003
|
Silk waste
|
124.
|
5101
|
Wool, not carded or combed
|
125.
|
5102
|
Fine or coarse animal hair, not carded or combed
|
126.
|
5103
|
Waste of wool or of fine or coarse animal hair
|
127.
|
52
|
Gandhi Topi
|
128.
|
52
|
Khadi yarn
|
129.
|
5303
|
Jute fibres, raw or processed but not spun
|
130.
|
5305
|
Coconut, coir fibre
|
131.
|
63
|
Indian National Flag
|
132.
|
6703
|
Human hair, dressed, thinned, bleached or otherwise worked
|
133.
|
6912 00 40
|
Earthen pot and clay lamps
|
134.
|
7018
|
Glass bangles (except those made from precious metals)
|
135.
|
8201
|
Agricultural implements manually operated or animal driven i.e. Hand tools, such as spades, shovels, mattocks, picks, hoes, forks and rakes; axes, bill hooks and similar hewing tools; secateurs and pruners of any kind; scythes, sickles, hay knives, hedge shears, timber wedges and
other tools of a kind used in agriculture, horticulture or forestry.
|
136.
|
8445
|
Amber charkha
|
137.
|
8446
|
Handloom [weaving machinery]
|
138.
|
8802 60 00
|
Spacecraft (including satellites) and suborbital and spacecraft launch
vehicles
|
S.
No.
|
Chapter or Heading or Sub-heading or Tariff item
|
Description of Goods
|
(1)
|
(2)
|
(3)
|
139.
|
8803
|
Parts of goods of heading 8801
|
140.
|
9021
|
Hearing aids
|
141.
|
92
|
Indigenous handmade musical instruments
|
142.
|
9603
|
Muddhas made of sarkanda and phool bahari jhadoo
|
143.
|
9609
|
Slate pencils and chalk sticks
|
144.
|
9610 00 00
|
Slates
|
145.
|
9803
|
Passenger baggage
|
146.
|
Any chapter
|
Puja samagri namely,-
|
147.
|
|
Liquefied petroleum gas for supply to household and non domestic exempted category (NDEC) customers
|
148.
|
|
Kerosene oil sold under PDS
|
149.
|
|
Postal baggage transported by Department of Posts
|
150.
|
|
Natural or cultured pearls and precious or semi-precious stones; precious metals and metals clad with precious metal (Chapter
71)
|
151.
|
|
Jewellery, goldsmiths’ and silversmiths’ wares and other
articles (Chapter 71)
|
152.
|
|
Currency
|
153.
|
|
Used personal and household effects
|
154.
|
|
Coral, unworked (0508) and worked coral (9601);
|
PART-A
|
|
|
A.1
|
GSTIN of Recipient
|
|
A.2
|
Place of Delivery
|
|
A.3
|
Invoice or Challan Number
|
|
A.4
|
Invoice or Challan Date
|
|
A.5
|
Value of Goods
|
|
A.6
|
HSN Code
|
|
A.7
|
Reason for Transportation
|
|
A.8
|
Transport Document Number
|
|
PART-B
|
|
|
B.
|
Vehicle Number
|
|
Number of E-Way Bills
|
|
E-Way Bill Number
|
|
|
|
|
|
|
|
|
Part A
|
|
Name of the Officer
|
|
Place of inspection
|
|
Time of inspection
|
|
Vehicle Number
|
|
E-Way Bill Number
|
|
Invoice or Challan or Bill Date
|
|
Invoice or Challan or Bill Number
|
|
Name of person in-charge of vehicle
|
|
Description of goods
|
|
Declared quantity of goods
|
|
Declared value of goods
|
|
Brief description of the discrepancy
|
|
Whether goods were detained?
|
|
If not, date and time of release of vehicle
|
|
Part B
|
|
Actual quantity of goods
|
|
Actual value of the Goods
|
|
Tax payable
|
|
Integrated tax
|
|
Central tax
|
|
State or UT tax
|
|
Cess
|
|
Penalty payable
|
|
Integrated tax
|
|
Central tax
|
|
State or UT tax
|
|
Cess
|
|
Details of Notice
|
|
Date
|
|
Number
|
|
Summary of findings
|
E-Way Bill Number
|
|
Approximate Location of detention
|
|
Period of detention
|
|
Name of Officer in- charge
|
(if known)
|
Date
|
|
Time
|
|
IRN:
|
|
Date:
|
|
|||||
Details of Supplier
|
||||||||
GSTIN
|
|
|||||||
Legal Name
|
|
|||||||
Trade name, if any
|
|
|||||||
Address
|
|
|||||||
Serial No. of Invoice
|
|
|||||||
Date of Invoice
|
|
|||||||
|
Details of Recipient (Billed to)
|
Details of Consignee (Shipped to)
|
||||||
GSTIN or UIN, if
available
|
|
|
||||||
Name
|
|
|
||||||
Address
|
|
|
||||||
State (name and code)
|
|
|
||||||
Type of supply –
|
||||||||
|
B to B supply
|
|||||||
|
B to C supply
|
|||||||
|
Attracts Reverse Charge
|
|||||||
|
Attracts TCS
|
GSTIN of operator
|
|
|||||
|
Attracts TDS
|
GSTIN of TDS Authority
|
|
|||||
|
Export
|
|||||||
|
Supplies made to SEZ
|
|||||||
|
Deemed export
|
|||||||
|
|
|
|
|
|
|
|
|
Sr.
No.
|
Description of Goods
|
HS N
|
Qty.
|
Uni t
|
Price (per unit)
|
Tota l valu e
|
Discoun t, if any
|
Taxabl e value
|
Central tax
|
State or UT tax
|
Integrated tax
|
Cess
|
||||
Rate
|
Amt.
|
Rate
|
Amt.
|
Rate
|
Am t.
|
Ra te
|
A
mt
.
|
|||||||||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Freight
|
|
|
|
|
|
|
|
|
|
|
|
||||
|
|
Insurance
|
|
|
|
|
|
|
|
|
|
|
|
|||||
|
Packing and Forwarding Charges etc.
|
|
|
|
|
|
|
|
|
|
|
|
||||
Total
|
|
|
|
|
|
|
|
|
|
|
|
|||||
Total Invoice Value (In figure)
|
|
|
|
|
||||||||||||
Total Invoice Value (In Words)
|
|
1.
|
Name of the State
|
|
||||||
2.
|
(a) Legal name
|
|
||||||
|
(b) Trade Name, if any
|
|
||||||
(c) PAN
|
|
|||||||
(d) Aadhaar (applicable in case of proprietorship concerns only)
|
|
|||||||
3.
|
Type of enrolment
|
|||||||
(i) Warehouse or Depot
|
|
(ii) Godown
|
|
|||||
(iii) Transport services
|
|
(iv) Cold Storage
|
|
|||||
4.
|
Constitution of Business (Please Select the Appropriate)
|
|||||||
(i) Proprietorship or HUF
|
|
(ii) Partnership
|
|
|||||
(iii) Company
|
|
(iv) Others
|
|
|||||
5.
|
Particulars of Principal Place of Business
|
|||||||
(a)
|
Address
|
|||||||
Building No. or Flat No.
|
|
Floor No.
|
|
|||||
Name of the Premises or Building
|
|
Road or Street
|
|
|||||
City or Town or Locality or
Village
|
|
Taluka or Block
|
|
|||||
District
|
|
|
|
|||||
State
|
|
PIN Code
|
|
|||||
Latitude
|
|
Longitude
|
|
|||||
(b)
|
Contact Information (the email address and mobile number will be used for authentication)
|
|||||||
Email Address
|
|
Telephone
|
STD
|
|
||||
|
|
|
|
|
|
|
|
|
Mobile Number
|
|
Fax
|
STD
|
|
|||||
(c)
|
Nature of premises
|
||||||||
Own
|
Leased
|
Rented
|
Consent
|
Shared
|
Others (specify)
|
||||
6.
|
Details of additional place of business – Add for additional place(s) of business, if any(Fill up the same information as in item 5 [(a), (b), and (c)]
|
||||||||
7.
|
Consent
|
||||||||
I on behalf of the holder of Aadhaar number
|
|||||||||
8. List of documents uploaded (Identity and address proof)
|
|||||||||
9. Verification
I hereby solemnly affirm and declare that the information given herein above is true and correct to the best of my knowledge and belief and nothing has been concealed therefrom.
Place: Signature
Date: Name of Authorised Signatory
|
|||||||||
For Office Use:
|
|||||||||
Enrolment no
|
Date- ”.
|
||||||||
|
|
|
|
|
|
|
|
|
|
1.
|
GSTIN /
Temporary ID
|
|
2.
|
Legal Name
|
|
3.
|
Trade Name, if any
|
|
4.
|
Address
|
|
|
|
|
||||||||||
5.
|
Tax period
(if applicable)
|
From
|
||||||||||
6.
|
Amount of Refund Claimed (Rs.)
|
Act
|
Tax
|
Interest
|
Penalty
|
Fees
|
Others
|
Total
|
||||
Central tax
|
|
|
|
|
|
|
||||||
State / UT
tax
|
|
|
|
|
|
|
||||||
Integrated tax
|
|
|
|
|
|
|
||||||
Cess
|
|
|
|
|
|
|
||||||
Total
|
|
|
|
|
|
|
||||||
7.
|
Grounds of refund claim (select from drop down)
|
(a)
|
Excess balance in Electronic Cash Ledger
|
|||||||||
(b)
|
Exports of services- with payment of tax
|
|||||||||||
(c)
|
Exports of goods / services- without payment of tax (accumulated
ITC)
|
|||||||||||
(d)
|
On account of order
|
|||||||||||
Sr.
No.
|
Type of order
|
Order no.
|
Order date
|
Order Issuing Authority
|
Payment reference no., if
any
|
|||||||
(i)
|
Assessment
|
|
|
|
|
|||||||
(ii)
|
Provisional
assessment
|
|
|
|
|
|||||||
(iii)
|
Appeal
|
|
|
|
|
|||||||
(iv)
|
Any other order
(specify)
|
|
|
|
|
|||||||
(e)
|
ITC accumulated due to inverted tax structure
[clause (ii) of first proviso to section 54(3)]
|
|||||||||||
(f)
|
On account of supplies made to SEZ unit/ SEZ developer (with payment of tax)
|
|||||||||||
(g)
|
On account of supplies made to SEZ unit/ SEZ developer (without payment of tax)
|
|||||||||||
(h)
|
Recipient of deemed export
|
|||||||||||
(i)
|
Tax paid on a supply which is not provided, either wholly or
partially, and for which invoice has not been issued (tax paid on advance payment)
|
|||||||||||
(j)
|
Tax paid on an intra-State supply which is subsequently held to be inter-State supply and vice versa(change of POS)
|
|||||||||||
(k)
|
Excess payment of tax, if any
|
|||||||||||
(l)
|
Any other (specify)
|
|||||||||||
8.
|
Details of Bank account
|
Name of
bank
|
Address of
branch
|
IFSC
|
Type of
account
|
Account No.
|
||||||
|
|
|
|
|
||||||||
9.
|
Whether Self-Declaration filed by Applicant u/s 54(4), if applicable
|
Yes No
|
||||||||||
|
|
|
|
|
|
|
|
|
|
|
|
|
DECLARATION [second proviso to section 54(3)]
I hereby declare that the goods exported are not subject to any export duty. I also declare that I have not availed any drawback on goods or services or both and that I have not claimed refund of the integrated tax paid on supplies in respect of which refund is claimed.
Signature Name –
Designation / Status
|
DECLARATION [rule 89(2)(f)]
I hereby declare that the Special Economic Zone unit /the Special Economic Zone developer has not availed of the input tax credit of the tax paid by the applicant, covered under this refund claim.
Signature Name –
Designation / Status
|
|
|
|
|
SELF- DECLARATION [rule 89(2)(l)]
I (Applicant) having GSTIN/ temporary Id-------- , solemnly affirm
and certify that in respect of the refund amounting to Rs---- / with respect to the tax, interest,
or any other amount for the period from---to----, claimed in the refund application, the incidence of such tax and interest has not been passed on to any other person.
Signature Name –
Designation / Status
(This Declaration is not required to be furnished by applicants, who are claiming refund under clause (a) or clause (b) or clause (c) or clause (d) or clause (f) of sub-section (8) of section 54.)
|
10. Verification
I/We <Taxpayer Name> hereby solemnly affirm and declare that the information given herein above is true and correct to the best of my/our knowledge and belief and nothing has been concealed therefrom.
I/We declare that no refund on this account has been received by me/us earlier.
Date
(Name)
Designation/ Status
Turnover of inverted rated supply of goods
|
Tax payable on such inverted rated supply of
goods
|
Adjusted total turnover
|
Net input tax credit
|
Maximum refund amount to be claimed [(1×4÷3)-2]
|
1
|
2
|
3
|
4
|
5
|
|
|
|
|
|
Sr. No.
|
Invoice details
|
Integrated tax
|
BRC/ FIRC
|
Integrated tax involved in debit note, if
any
|
Integrated tax involved in credit
note, if any
|
Net Integrated tax
(6+9 - 10)
|
||||
No.
|
Date
|
Value
|
Taxable value
|
Amt.
|
No.
|
Date
|
||||
1
|
2
|
3
|
4
|
5
|
6
|
7
|
8
|
9
|
10
|
11
|
|
|
|
|
|
|
|
|
|
|
|
Sr. No.
|
Invoice details
|
Goods/ Services
(G/S)
|
Shipping bill/ Bill of export
|
EGM Details
|
BRC/ FIRC
|
||||||
No.
|
Date
|
Value
|
Port code
|
No.
|
Date
|
Ref No.
|
Date
|
No.
|
Date
|
||
1
|
2
|
3
|
4
|
5
|
6
|
7
|
8
|
9
|
10
|
11
|
12
|
|
|
|
|
|
|
|
|
|
|
|
|
Turnover of zero rated supply of goods and
services
|
Net input tax credit
|
Adjusted total turnover
|
Refund amount (1×2÷3)
|
1
|
2
|
3
|
4
|
|
|
|
|
GSTIN of
recipient
|
Invoice details
|
Shipping bill/ Bill of export/ Endorsed
invoice by SEZ
|
Integrated Tax
|
Integrated tax involved in debit note, if any
|
Integrated tax involved in credit note, if any
|
Net Integrated tax
(8+ 9 –
10)
|
||||
No.
|
Date
|
Value
|
No.
|
Date
|
Taxable Value
|
Amt.
|
||||
|
|
|
|
|
|
|
|
|
|
|
1
|
2
|
3
|
4
|
5
|
6
|
7
|
8
|
9
|
10
|
11
|
|
|
|
|
|
|
|
|
|
|
|
Sr. No.
|
Invoice details
|
Goods/ Services (G/S)
|
Shipping bill/ Bill of export/
Endorsed invoice no.
|
|||
No.
|
Date
|
Value
|
No.
|
Date
|
||
1
|
2
|
3
|
4
|
5
|
6
|
7
|
Turnover of zero rated supply of goods and services
|
Net input tax credit
|
Adjusted total turnover
|
Refund amount (1×2÷3)
|
1
|
2
|
3
|
4
|
|
|
|
|
GSTIN/ UIN
Name
(in case B2C)
|
Details of invoices covering transaction considered as intra –State
/ inter-State transaction earlier
|
Transaction which were held inter State / intra-State supply subsequently
|
||||||||||||
Invoice details
|
Integrated tax
|
Central tax
|
State/ UT
tax
|
Cess
|
Place of Supply
|
Integrated tax
|
Central tax
|
State/ UT
tax
|
Cess
|
Place of Supply
|
||||
No.
|
Date
|
Value
|
Taxable Value
|
|||||||||||
1
|
2
|
3
|
4
|
5
|
6
|
7
|
8
|
9
|
10
|
11
|
12
|
13
|
14
|
15
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Tax period
|
ARN of return
|
Date of filing return
|
Tax Payable
|
|||
Integrated tax
|
Central tax
|
State/ UT tax
|
Cess
|
|||
1
|
2
|
3
|
4
|
5
|
6
|
7
|
|
|
|
|
|
|
|
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