THE KERALA VALUE ADDED TAX RULES, 2005
FORM No. 21 CC
APPLICATION For claiming refund of input tax remaining unadjusted at the end of the year
(See Rule 47 A)
To
The Assessing Authority
I/We ................................. (give full address) hereby apply for refund of Rs..................... (in words........................) being amount of excess input tax remaining unadjusted as on 31st March, ................ (specify year) with reference to the Annual Return in Form No. 10 filed for the year ended 31st March, .............. (specify year) as detailed below month wise details to be attached in Annexure A.
DECLARATION
Certified that the particulars furnished herein are true and correct in all respects, that no refund had been claimed previously in respect of the same claim, that no refund adjustment had been availed of previously in respect of the same claim, that goods forming subject matter of refund claim have not suffered sales return and that no dues are outstanding against us under the Kerala Value Added Tax Act, the Kerala General Sales Tax Act, the Central Sales Tax Act or the Kerala Tax on Entry of Goods into Local Areas Act.
Month wise details to be enclosed in the annexure.
* Details of payment to be enclosed.
ANNEXURE
(a) Tax Credit
(b) Tax dues