FORM-GST-RFD-01 A
[See rules 89(1) and 97A]
Application for Refund (Manual)
(Applicable for casual taxable person or non-resident taxable person, tax deductor, tax collector and other registered taxable person)
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 of central excise duty/service tax/central tax 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 [section 54(3)(ii)]
I hereby declare that the refund of ITC claimed in the application does not include ITC availed on goods or services used for making 'nil' rated or fully exempt supplies.
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.
DECLARATION [rule 89(2)(g)]
(For recipients/supplier of deemed export)
In case of refund claimed by receipient
I hereby declare that the refund has been claimed only for those invoices which have been detailed in statement 5B for the tax period for which refund is being claimed and the amount does not exceed the amount of input tax credit availed in the valid return filed for the said tax period. I also declare that the supplier has not claimed refund with respect to the said supplies.
In case refund claimed by supplier
I hereby declare that the refund has been claimed only for those invoices which have been detailed in statement 5B for the tax period for which refund is being claimed. I also declare that the recipient shall not claim any refund with respect of the said supplies and also, the recipient has not availed any input tax credit on such supplies.
UNDERTAKING
I hereby undertake to pay back to the Government the amount of refund sanctioned along with interest in case it is found subsequently that the requirements of clause (c) of sub-section (2) of section 16 read with sub-section (2) of section 42 of the CGST/SGST Act have not been complied with in respect of the amount refunded.
SELF- DECLARATION [rule 89(2)(1)]
I/We (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.
(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.)
8. 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.
Annexure-1
Statement -1 [rule 89(5)]
Refund Type: ITC accumulated due to inverted tax structure [clause (ii) of first proviso to section 54(3)]
(Amount in Rs.)
Statement 1A
[see rule 89(2)(h)]
Statement 2: [rule 89(2)(c)]
Refund Type: Exports of services with payment of tax
Statement- 3 [rule 89(2)(b) and 89(2)(c)]
Refund Type: Export without payment of tax (accumulated ITC)
Statement- 3A [rule 89(4)]
Refund Type: Export without payment of tax (accumulated ITC) - calculation of refund amount
"Statement-4 [rule 89(2)(d) and 89(2)(e)]
Refund Type: On account of supplies made to SEZ unit or SEZ Developer (on payment of tax)
Statement-5A [rule 89(4)]
Refund Type: On account of supplies made to SEZ unit / SEZ developer without payment of tax (accumulated ITC) - calculation of refund amount
Statement 5B
[rule 89(2)(g)]
Refund Type: On account of deemed exports
(Amount in Rs)