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

FORM No. 21 KA

REFUND PAYMENT ORDER

[See Rule 50]

Book No.

Leaf No.

Name of the Treasury

Treasury Code:

Computer Sequence No..

Date

Scroll No.

Voucher No.

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

DDO Code :

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

Dept Code

DDO

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

Head of Account

Book No.

Order for the refund of tax / security deposit / other amount (to specify) payable at the Government Treasury within Thirty days from the date of issue.

The Treasury Officer

Certified that an amount of Rs……… (Rupees…………………… is due to Sri./Smt./M/s……………………………………… / PIN (if any) ……………… refund for the period from …… to…………… As per the provisions of KVAT Act, 2003.

Certified that the refund has been sanctioned as per Order No………… dated……………… of ……………………………………………… sanctioning authority).

Certified that the refund of the said amount covered by this order had not been granted previously.

Therefore I hereby authorize for the payment of refund of Rs…………

(Rupees. ………………………… to Sri./Smt./M/s……………………………… on presentation of the refund voucher in original.

Place
of 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 T.C.

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

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

Accountant	Treasury Officer

Received Pay Order Cheque	Pay Order Cheque Issued

Signature of Recipient	Accountant