THE KERALA VALUE ADDED TAX RULES, 2005 - Forms
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THE KERALA VALUE ADDED TAX RULES, 2005

FORM NO. 21E

APPLICATION FOR REIMBURSEMENT OF TAX TO UN AGENCIES ETC.

[See Rule 49 (1)]

The Registering/ Assessing Authority

(with Office Address)

In pursuance of the provisions contained under section 14 of the Kerala Value Added Tax Act, 2003 and the Rules made thereunder, the undersigned request you to grant reimbursement of tax collected from us as per details shown hereunder:

1	Name and address of the United Nation Agency/ Diplomatic Mission/ Consulate etc.
2	Name and address of the seller with Tax payers Identification No.
3	Description of goods purchased (with schedule No.& Entry No./ HSN Code)
4	Details of purchase	Invoice No.	Date	Amount
5	Tax charged in the invoice(s) for which reimbursement sought	Rs

Place :

Date:

Seal

Name, Signature & Status Of the selling dealer/Authorised Signatory

ENCLOSURE : Authenticated copy of Tax Invoice(s).

Note:- The application shall be filed with the Commercial Taxes Office where the seller is registered.