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THE KERALA GOODS AND SERVICES TAX FORMS 2017
-

Body

KFC RFD-1

[See rule 3A (1)]

Application for Refund of Kerala Flood Cess

1. GSTIN :    
2. Name :    

3.

 Address :    

4.

 Tax period : From
MM YYYY
 To
MM YYYY

5.

 Amount of refund claimed :    

1

 Kerala Flood cess  

2

 Interest  

3

 Penalty  

4

 Total  
 

6. Grounds of refund Claim. (Mark whichever is applicable.),-

    (i) flood cess collected from a recipient of goods or services for which flood cess was not leviable;

    (ii) flood cess collected and paid, but the corresponding supply has not been completed;

    (iii) multiple e-payments of same flood cess due amounts made along with return due to technical defects in the treasury payment gateway;

    (iv) Refund on account of appeal.

7. If the application of refund is filed on account of appeal,-

    (a) Order No........

    (b) Date......

8. Details of Bank Account as per registration data provided in GSTIN

1

 Name of Bank  

2

 Address of Branch  

3.

 IFSC  

4.

 Type of Account  

5.

 Account No.  

UNDERTAKING

I hereby undertake to pay back to the Government the amount of refund sanctioned along with interest in case it is found subsequently that the information furnished by the undersigned is found false/incorrect in subsequent verification.

Place  
Date  
  Signature
  Name
  Designation /Status