Download Application for Refund of Amount Forfeited

Form A-V Application for Refund of Amount Forfeited under section 44 of the Bihar Value Added Tax Ordinance, 2005 [See rule 31(3)] Office of the .................................................................................. of Commercial Taxes ...................................................................................Circle To, The ........................................................................... .................................................................................................................... circle. I ................................................................................................... (full name), son of ...................................................................................................... (full name) hereby apply for the refund of the amount forfeited under section 44 of the Bihar Value Added Tax Ordinance, 2005 and furnish the following particular for that purpose - 1. Name and style and complete address of the person/firm from whom tax was collected in contravention of sub-sections(1) & (2) of section 43 ......................................................................................................................................................................................................................................................................................... ......................................................................................................................................................................................................................................................................................... 2. Taxpayer Identification No., if any, of the firm ............................................................................................................................................ mentioned above at Serial (1). 3. Name and style and complete address of the firm collecting the tax in contravention of sub­sections(1) & (2) of section 43 ......................................................................................................................................................................................................................................................................................... ......................................................................................................................................................................................................................................................................................... 4. Taxpayer Identification No., if any, of the firm ............................................................................................................................................ mentioned above at Serial (3). 5. Number and date of invoice/invoices vide which the tax was collected in contravention of sub-sections (1) and (2) of section 43 ......................................................................................................................................................................................................................................................................................... ......................................................................................................................................................................................................................................................................................... 6. Value of goods, tax charged thereon and full value of the invoice/invoices mentioned at serial number (5) above: ......................................................................................................................................................................................................................................................................................... ......................................................................................................................................................................................................................................................................................... (Attach Copy) DECLARATION I do hereby declare that the particulars furnished in this application are correct and complete to the best of my knowledge and belief. Place ................................................... Signature of the Applicant .......................................................... Date ................................................... Status/Designation .................................................................................