The Assam Value Added Tax Rules, 2005. Forms
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THE ASSAM VALUE ADDED TAX RULES, 2005

FORM-37

[See Rule 29]

APPLICATION FOR REFUND

01-Registration Number

02-Name and address of the person claiming refund.

03-Name and style of the business together with number of the Certificate of Registration, if any.

04-Period of return for which refund is claimed.

05-Amount already paid together with challan no. and date of payment; and

06- The amount of refund claimed and grounds thereof.

07-Whether adjustment sought for against liability of any other return period, please specify in details.

08-Net Amount of refund after adjustment, if any, in item 07. above.

VERIFICATION

I_____________________(Proprietor/director/secretary or other authorised person) hereby declare that the particulars given herein are correct and hereby apply for refund under the Assam Value Added Tax Act, 2003.

Signature of Taxpayer or Authorised Officer.

Tax Office

Date of receipt of the application

D		M		Y

Received by____