Acknowledgment
FORM SBY-04
GST
1[FORM SBY-04
Acknowledgment
Applicant‟s Name:
SBY-UIN:
Acknowledgement Number :
Applicant‟s Name :
Your application for reimbursement is hereby acknowledged against
Reimbursement Claim Details
Claim Period
Date and Time of Filing
Amount Claimed
Central Tax
Integrated Tax (50% of the Integrated Tax paid)
Total
Date:
Place:
(Signature of nodal officer)
Name of the nodal officer:
Designation of the nodal officer:]
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