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

1. GSTIN: 2. Name: 3. Address: 4. Tax Period (Monthly/Quarterly) : From < DD/MM/YY > To < DD/MM/YY > 5. Amount of Refund Claim: < INR > < In Words > 6. Details of inward supplies of goods received and corresponding outward supplies: DETAILS OF SUPPLIES Inward Supplies Corresponding outward supplies GSTIN of supplier Invoice details Rate Taxable value Amount of tax Invoice details No / Date. HSN Code Qty. Value Integrated Tax Central Tax State /UT Tax Cess No . / Date HSN Code Qt y. Taxable Value 7. Refund applied for : Central Tax State/UT Tax Integrated Tax Cess Total < Total > < Total > < Total > < Total > < Total > 8. Details of Bank Account : i. Bank Account Number ii. Bank Account Type iii. Name of the Bank iv. Name of the Account Holder/Operator v. Address of Bank Branch vi. IFSC vii. MICR 9. Declaration: I _______ as an authorized representative of ___________(Name of Duty Free Shop/Duty Paid Shop – retail outlet) hereby solemnly affirm and declare that,- (i) refund has not been claimed against any of the invoices in respect of outward supplies submitted with this application. (ii) the information given herein above is true and correct to the best of my knowledge and belief. Signature of Authorized Signatory: Name: Designation / Status Date: Place: Instructions: 1. Application for refund shall be filed on monthly/quarterly basis depending upon the frequency of furnishing of return by retail outlets. 2. Application shall be made in respect of one inward supply invoice only once. Therefore, it is advised that refund shall be applied only for those inward supply invoices the goods received against which have been completely supplied. 3. Applicant should ensure that all the invoices declared by him have the GSTIN of the supplier and the GSTIN of the respective Duty Free Shop /Duty Paid Shop (retail outlet) clearly marked on them. 4. Documents to be attached with the refund application: a) Undertaking that all indigenous goods on which refund is being claimed have been received by the Duty-Free Shop/Duty Paid Shop (retail outlet); b) Undertaking that the indigenous goods have been sold to eligible outgoing international tourist; c) Copy of the returns for the period for which application is being filed.] Notes 1. Inserted vide Notification No. 31/2019 – Central Tax dated 28-06-2019 w.e.f. 01-07-2019