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

FORM No. 21 K

REFUND ORDER

[See Rule 46.47.47A]

TREASURY DETAILS

Name of the Treasury

Computer Sequence No./Token No.

Date

Scroll No.

Voucher No.

of..........I/II LOP

DDO Code :

Designation..........................................

Dept Code

DDO

Office....................................................

No.

Tax payers Identification No

Value Added Tax OFFICER ADDRESS

Central Sales Tax No.

Name and Address of the Dealer :

Having considered the application for refund of input tax paid under rule 46/47/47A as per form No 21B/21C/21CC filed on.............. I hereby order to grant refund of Rs................................ to Sri/M/s.................................. and Address with Tax payers Identification No).

Certified that no for the refund of the above amount has been previously granted.

Place
Date	Seal	Name, Designation and
		Signature of the Assessing
		Authority

FOR TREASURY USE ONLY

Pay Rs......................(Rupees............................ only) in CASH, Rs......................(Rupees............................ only) by RBR and Rs....................(Rupees........................ only) by Treasury Chalan.

POC No.......................................

Dated .................................

Accountant	Treasury Officer

Received Pay Order Cheque	Pay Order Cheque Issued By

Signature of Recipient	Accountant

ACKNOWLEDGEMENT

Received the Refund Order No..............................dated............................for Rs........(Rupees......................only).

Place:	Name,Status & Signature
Date:	of the dealer / Authorised
	Signatory

Seal