Application for Refund (Manual) – [See rules 89(1) and 97A]
GST RFD – 01A
GST
7[FORM-GST-RFD-01 A
[See rules 89(1) and 97A]
Application for Refund (Manual)
(Applicable for casual taxable person or non-resident taxable person, tax deductor, tax collector and other registered taxable person)
1.
GSTIN / Temporary ID
2.
Legal Name
3.
Trade Name, if any
4.
Address
5.
Tax period (if applicable)
From To
6.
Amount of Refund Claimed (Rs.)
Act
Tax
Interest
Penalty
Fees
Others
Total
Central tax
State / UT tax
Integrated tax
Cess
Total
7.
Grounds of Refund Claim (select from drop down)
(a)
Excess balance in Electronic Cash Ledger
(b)
Exports of services- with payment of tax
(c)
Exports of goods / services- without payment of tax (accumulated ITC)
(d)
ITC accumulated due to inverted tax structure [under clause (ii) of first proviso to section 54(3)]
(e)
On account of supplies made to SEZ unit/ SEZ developer (with payment of tax)
(f)
On account o
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on 54(3)(ii)]
I hereby declare that the refund of ITC claimed in the application does not include ITC availed on goods or services used for making 'nil' rated or fully exempt supplies.
Signature
Name –
Designation / Status
8[DECLARATION [rule 89(2)(f)]
I hereby declare that tax has not been collected from the Special Economic Zone unit /the Special Economic Zone developer in respect of supply of goods or services or both covered under this refund claim.
Signature Name –
Designation / Status]
DECLARATION [rule 89(2)(g)]
(For recipient/supplier of deemed export)
In case refund claimed by recipient__
I hereby declare that the refund has been claimed only for those invoices which have been detailed in statement 5B for the tax period for which refund is being claimed and the amount does not exceed the amount of input tax credit availed in the valid return filed for the said tax period. I also declare that the supplier has not claimed refund with respect to the said supplies.
In
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or any other amount for the period fromto-, claimed in the refund application, the incidence of such tax and interest has not been passed on to any other person.
Signature
Name –
Designation / Status
(This Declaration is not required to be furnished by applicants, who are claiming refund under clause (a) or clause (b) or clause (c) or clause (d) or clause (f) of sub- of sub-section (8) of section 54.)
8. Verification
I/We hereby solemnly affirm and declare that the information given herein above is true and correct to the best of my/our knowledge and belief and nothing has been concealed therefrom.
I/We declare that no refund on this account has been received by me/us earlier.
Place
Date
Signature of Authorised Signatory
(Name)
Designation/ Status
Annexure-1
Statement -1 [rule 89(5)]
Refund Type: ITC accumulated due to inverted tax structure [clause (ii) of first proviso to section 54(3)]
(Amount in Rs.)
Turnover of inverted rated
supply of goods and services
Tax p
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an GSTIN of applicant (recipient).
Statement- 2 [rule 89(2)(c)]
Refund Type: Exports of services with payment of tax
(Amount in Rs.)
Sr. No.
Invoice details
Integrated tax
Cess
BRC/ FIRC
Integrated tax and cess involved in debit note, if any
Integrated tax and cess involved in credit note, if any
Net Integrated tax and cess (6+7+10 – 11)
No.
Date
Value
Taxable value
Amt.
No.
Date
1
2
3
4
5
6
7
8
9
10
11
12
Statement- 3 [rule 89(2)(b) and 89(2)(c)]
Refund Type: Export without payment of tax (accumulated ITC) (Amount in Rs.)
Sr. No.
Invoice details
Goods/ Services (G/S)
Shipping bill/ Bill of
export
EGM Details
BRC/ FIRC
No.
Date
Value
Port code
No.
Date
Ref No.
Date
No.
Date
1
2
3
4
5
6
7
8
9
10
11
12
Statement- 3A [rule 89(4)]
Refund Type: Export without payment of tax (accumulated ITC) – calculation of refund amount
(Amount in Rs.)
Turnover of zero rated supply of goods and services
Net input tax credi
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Amount in Rs)
Sl.
No.
Details of invoices/credit notes/debit notes of outward supplies in case refund is claimed by supplier/Details of invoices of inward supplies in case refund is claimed by recipient
Tax paid
GSTIN of the supplier
No.
Date
Taxable Value
Type
(Invoice/ Credit
Note/
Debit
Note)
Integrated Tax
Central Tax
State
Tax
/Union
territory
Tax
Cess
1
2
3
4
5
6
7
8
9
10
]
Statement-6 [rule 89(2)(j)]
Refund Type: On account of change in POS (inter-State to intra-State and vice versa)
Order Details (issued in pursuance of sections 77(1) and 77(2), if any:
Order No:
Order Date:
(Amount in Rs.)
Recipients' GSTIN/ UIN Name (in case B2C)
Invoice details
Details of tax paid on transaction considered as intra -State / inter-State transaction earlier
Taxes re-assessed on transaction which were held inter State / intra- State supply subsequently
Integrated tax
Central tax
State/ UT tax
Cess
Place of Supply
Integrated tax
Central ta
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port duty. I also declare that I have not availed any drawback on goods or services or both and that I have not claimed refund of the integrated tax paid on supplies in respect of which refund is claimed.
Signature
Name –
Designation / Status
7. Substituted vide Notification No. 74/2018 – Central Tax dated 31-12-2018 before it was read as
“1[FORM-GST-RFD-01 A
[See rules 89(1) and 97A]
Application for Refund (Manual)
(Applicable for casual taxable person or non-resident taxable person, tax deductor, tax collector and other registered taxable person)
1.
GSTIN/Temporary ID
2.
Legal Name
3.
Trade Name, if any
4.
Address
5.
Tax period (if applicable)
From To
6.
Amount of Refund Claimed(Rs.)
Act
Tax
Interest
Penalty
Fees
Others
Total
Central tax
State/UT tax
Integrated tax
Cess
Total
7.
Grounds of Refund Claim (select from drop down)
(a)
Excess balance in Electronic Cash Ledger
(b)
Exports of services- with payment of tax
(c)
Exports of goods/service
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pt supplies.
Signature Name –
Designation / Status
DECLARATION [rule 89(2)(f)]
I hereby declare that the Special Economic Zone unit /the Special Economic Zone developer has not availed of the input tax credit of the tax paid by the applicant, covered under this refund claim.
Signature
Name –
Designation / Status
3[DECLARATION [rule 89(2)(g)]
(For recipient/supplier of deemed export)
In case refund claimed by recipient __
I hereby declare that the refund has been claimed only for those invoices which have been detailed in statement 5B for the tax period for which refund is being claimed and the amount does not exceed the amount of input tax credit availed in the valid return filed for the said tax period.I also declare that the supplier has not claimed refund with respect to the said supplies.
In case refund claimed by supplier __
I hereby declare that the refund has been claimed only for those invoices which have been detailed in statement 5B for the tax period for which
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me –
Designation / Status
(This Declaration is not required to be furnished by applicants, who are claiming refund under clause (a) or clause (b) or clause (c) or clause (d) or clause (f) of sub-section (8) of section 54.)
8. Verification
I/We hereby solemnly affirm and declare that the information given herein above is true and correct to the best of my/our knowledge and belief and nothing has been concealed therefrom.
I/We declare that no refund on this account has been received by me/us earlier.
Place
Date
Signature of Authorised Signatory
(Name)
Designation/ Status
Annexure-1
Statement -1 [rule 89(5)]
Refund Type: ITC accumulated due to inverted tax structure [clause (ii) of first proviso to section 54(3)]
(Amount in Rs.)
Turnover of inverted rated supply of goods
Tax payable on such inverted rated supply of goods
Adjusted total turnover
Net input tax credit
Maximum refund amount to be claimed [(1×4÷3)-2]
1
2
3
4
5
3[Statement 1A [rule 89(2)(
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ce details
Goods/Services (G/S)
Shipping bill/ Bill of export
EGM Details
BRC/ FIRC
No.
Date
Value
Port code
No.
Date
Ref No.
Date
No.
Date
1
2
3
4
5
6
7
8
9
10
11
12
]
Statement- 3A [rule 89(4)]
Refund Type: Export without payment of tax (accumulated ITC) – calculation of refund amount
(Amount in Rs.)
Turnover of zero rated supply of goods and services
Net input tax credit
Adjusted total turnover
Refund amount (1×2÷3)
1
2
3
4
5[Statement-4 [rule 89(2)(d) and 89(2)(e)]
Refund Type: On account of supplies made to SEZ unit or SEZ Developer (on payment of tax)
(Amount in Rs.)
GSTIN of recipient
Invoice details
Shipping bill/ Bill of export/ Endorsed invoice by SEZ
Integrated Tax
Cess
Integrated tax and cess involved in debit note, if any
Integrated tax and cess involved in credit note, if any
Net Integrated tax and cess (8+9+10-11)
No.
Date
Value
No.
Date
Taxable Value
Amt.
1
2
3
4
5
6
7
8
9
10
11
12
]
St
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