GST RFD - 10A, Integrated Tax (GST-FORMS)

1. GSTIN : 2. Name : 3. Address : 4. Tax Period (Quarter) : From To 5. Amount of Refund Claim : 6. Details of inward supplies of goods received: GSTIN of Supplier Invoice/Debit Note/Credit Note details Rate Taxable Value Amount of tax No. Date Value Integrated Tax Central Tax State/ Union territory Tax 1 2 3 4 5 6 7 8 9 6A. Invoices received To 6B. Debit/Credit Note received a1 refund applied for: Central Tax State /Union territory Tax Integrated Tax Total 8. Details of Bank Account: a. Bank Account Number b. Bank Account Type c. Name of the Bank d. Name of the Account Holder e. Address of Bank Branch f. IFSC g. MICR 9. Attachment of the following documents with the refund application : a. Copy of FORM GSTR-3B for the period for which application has been filed b. Copy of FORM GSTR-2A for the period for which application has been filed 10. Verification I _______ as an authorised representative of << Name of Canteen Store Department>> 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. I further declare that all the goods, in respect of which the refund is being claimed, have been received by us and that no refund has been claimed earlier against any of the invoices against which refund has been claimed in this application. Date: Signature of Authorised Signatory: Place: Name: Designation / Status Instructions: 1. Application for refund shall be filed on quarterly basis. 2. Applicant should ensure that all the invoices declared by them have the GSTIN of the supplier and the GSTIN of the respective CSD clearly marked on them.] Notes 1. Inserted vide Circular No. 60/34/2018-GST dated 04-09-2018