(See sub-rule(15)of rule 41)
Government of Uttaranchal Department of Commercial Tax
Tax Adjustment Voucher
Book No.---- COUNTERFOIL Voucher No.------
Refund payable to--------------------------
(Name and address of person to whom refund is payable)
Assessment year----------------------------
G.I.R.No.------------
Date of order of refund--------------------
Authority ordering refund-----------------
Amount of refund Rs.----------------------
(Rs.----------------------------------------------)
(See sub-rule(15)of rule 41 )
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----------------------
(2) The amount concerning which this refund is given has been credited in the treasury as per particulars given below-
(a) State/Central
(b)Tax/Penalty/Fees/Miscellaneous/Interest
To be adjusted towards -
(c)Year ----------
as per Treasury challans enclosed
Sector---------Circle---------
Signature of --------------------------
recipient of voucher
Status --------------------------
Date of encashment ------------------
of voucher in Treasury/
Sub-Treasury/State Bank
Assistant Commissioner
(4) an amount of Rs.------------is out standing against the aforesaid dealer as tax /penalty/fee/interest/ miscellaneous under the Uttaranchal Value Added Tax/Central Sales Tax Act for the year----------------
or
the aforesaid dealer has requested that this amount of refund may be adjusted towards the tax /penalty/fee/interest / miscellaneous under the Uttaranchal Value Added Tax/Central Sales Tax Act for the year------------------
Hence please credit the aforesaid amount towards tax /penalty/fee/interest / miscellaneous under the Uttaranchal Value Added Tax/Central Sales Tax Act for the year-----------as per treasury challan enclosed and send two copies of receipt treasury challans to me.
Countersigned
Drawing and Disbursing Officer
Examined and adjusted Rs.--------------------
(Rs-----------------------------------------------)towards-------------under Uttaranchal Value Added Tax Act/ Central Sales Tax Act for the year-------
Treasury/Sub-Treasury Officer