Goods and Services Tax – FORM-SBY-03 – 1[FORM-SBY-03 Application for reimbursement of tax under the SevaBhojYojna Scheme 1. Name of the charitable/religious institution 2. Permanent Account Number (PAN) 3. GSTIN (if applicable) 4. Address 5. Unique Enrollment Number allotted by the Ministry of Culture 6. SBY-UIN 7. Claim period (relevant quarter) From < Year > < Month > to < Year >< Month > 8. Amount Claimed (Rs.) Central Tax Integrated Tax (50% of the Integrated Tax paid) Total 9. Details of invoices: GSTIN of the supplier Invoice No. Date Taxable Value Central Tax claimed as reimbursement Integrated Tax claimed as reimbursement (50% of the Integrated Tax paid) Total tax claimed as reimbursement (5+ 6) 1 2 3 4 5 6
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S&F) dated 01.08.2018. That the amount of tax claimed as reimbursement has been paid by us/me to the supplier, on the purchase of the items specified under the Seva Bhoj Yojna Scheme of the Ministry of Culture for providing the specified activity. That no reimbursement on this account for the claim period has been received by me/us earlier. That in case the amount sanctioned is found to be ineligible, the same shall be paid back to the Government with interest and penalty, as provided in para 14 of the Guidelines on the Scheme for Financial Assistance under Seva Bhoj Yojna issued by the Ministry of Culture, vide F.No. 13-1/2018-US (S&F) dated 01.08.2018. Signature of Authorised Signatory: Name: Designation / Status Date : Place : En
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