(See sub-rule(15)of rule 41)

Government of Uttaranchal Department of Commercial Tax

Tax Refund Order

Book No.----- COUNTERFOIL Voucher No.-----

Refund from the account of ------------------------------------------------------------------------------

(Name and address of the Dealer)

G.I.R.Number-------------------------------

Assessment year----------------------------

Refund payable to-----------------------------------

(Name and address of person to whom refund is payable)

Date of order of refund--------------------

Authority ordering refund-----------------

Amount of refund Rs.----------------------

(Rs.-------------------------------------------------------)

Nature of refund-

(a) State/Central

(b)Tax/Penalty/Fees/Miscellaneous/Interest

(See sub-rule(15)of rule 41)

Government of Uttaranchal Department of Commercial Tax

Tax Refund Order

Book No.----- ORIGINAL Voucher No.--------

To,

The Treasury /Sub-Treasury Officer / Officer- in- charge State Bank of India -------------------------

It is certified that-

(1) with reference to the assessment year----------a refund of Rs.------------------------------------------------------------------is due to Shri/Sarvshri---------- ------------------------

or

with reference to the assessment year-----------an amount of Rs.--------------was deposited by Shri/Sarvshri------------------------------,out of this amount Rs.------------is refundable Shri/Sarvshri------------------------------in accordance with rule 42;

(2) The amount concerning which this refund is given has been credited in the treasury as per particulars given below-

Assistant Commissioner

Sector---------Circle---------

Signature of --------------------------------

recipient of voucher

Status ---------------------------------

Date of encashment ------------------

of voucher in Treasury/

Sub-Treasury/State Bank

Assistant Commissioner

(3) no refund order regarding the aforesaid amount has previously been granted and that this order of refund has been entered in the original copy of the order granting refund and other relevant records under my signature with date;

Hence please pay to Shri/Sarvshri----------------------------------------------------a sum of Rs.----------- (Rs.---------------------------------------------------------)

on account of the refund and debit the amount under the head "0045-Commercial Tax-102-Receipts Uttaranchal Value Added Tax Ordinance, 2005-Deduct refunds"

Assistant Commissioner

Sector---------Circle---------

Countersigned

Drawing and Disbursing Officer