GST – GST RFD – 01A – 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 of supplies made to SEZ unit/ SEZ developer (without payment of tax) (g) Recipient of deemed export supplies/
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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 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
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nature 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 payable on such inverted rated supply of goods and services Adjusted total turnover Net input tax credit Maximum refund amount to be claimed [(1×4÷3)-2] 1 2 3 4 5 Statement 1
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, 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 credit Adjusted total turnover Refund amount (1×2÷3) 1 2 3 4 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
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ange 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 tax State/ UT tax Cess Place of Supply No. Date Value Taxable Value 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 Statement-7 [rule 89(2)(k)] Refund Type: Excess payment of tax, if any in case of last return filed. (Amount in Rs.) Tax period ARN of return Date of filing return Tax Paid in Excess Integrated tax Central tax State/ UT tax Cess 1 2 3 4 5 6 7 ] ******************** Notes-: 1. Inserted vide notification no. 55/2017 dated 15-11-2017 2. Substituted vide Notification No. 70/2017 Dated 21-12-2017,
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emporary 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 of supplies made to SEZ unit/ SEZ developer (without payment of tax) (g) 2[Recipient of deemed export supplies/Supplier of deemed export supplies] 6[DECLARATION [second proviso to section 54(3)] I hereby declare that the goods exported are not subject to any export duty. I also declare that I have not availed any drawback of central excise duty/service tax/centra
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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 refund is being claimed and the recipient shall not claim any refund with respect of the said supplies and also, the recipient has not availed any input tax credit on such supplies. Signature Name – Designation / Status 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 requirements of clause (c) of sub-section (2) of section 16 read with sub-section (2) of section 42 of the CGST/SGST Act have not been complied with in respect of the amount refunded. Signature Name – Designation / Status] SELF- DECLARATION [rule 89(2)(l)] I/We _
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erted 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)(h)] Refund type: ITC accumulated due to inverted tax structure [clause (ii) of first proviso to section 54(3)] Sl. No. Details of invoices of inward supplies received Tax paid on inward supplies Details of invoices of outward supplies issued Tax paid on outward supplies No. Date Taxable Value Integrated Tax Central Tax State/Un ion territory Tax No. Date Taxable Value Integrated Tax Central Tax State/Union territory Tax 1 2 3 4 5 6 7 8 9 10 11 12 13 ] 4[Statement- 2 [rule 89(2)(c)] Refund Type: Exports of services with payment of tax Sr. No. Invoice details Integrated tax Cess BRC/ FIRC Integrated tax and cess involved in debit note, if any Integrated tax and cess involv
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ote, 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 ] Statement-5A [rule 89(4)] Refund Type: On account of supplies made to SEZ unit / SEZ developer 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 3[Statement 5B [rule 89(2)(g)] Refund type: On account of deemed exports (Amount in Rs) Sl. No. Details of invoices 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 No. Date Taxable Value Integrated Tax Central Tax State /Union Territory Tax Cess 1 2 3 4 5 6 7 8 ] 8. Substituted vide Notification No. 03/2019-Central Tax dated 29-01-2019 before it was read as DECLARATION [rule 89(2)(f)] I hereby de
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