Form A-VIII Application for Refund under section 68 of the Bihar Value Added Tax Act, 2005 [See rule 43(2)] Office of the .................................................................................. of Commercial Taxes ...................................................................................Circle To, The ........................................................................... .................................................................................................................... Circle. I ................................................................................................... (full name), son of ...................................................................................................... (full name) on behalf of the dealer/ any other person whose particulars are detailed below, hereby apply for refund of excess tax/penalty - 1. Taxpayer Identification No. ........................................................................................................................................................................................ 2. Name of the Dealer ........................................................................................................................................................................................ 3. Style of Business ........................................................................................................................................................................................ 4. Location of Business ........................................................................................................................................................................................ 5. Period to which the refund relates ....................................................................................................................................................................... 6. Date of service of notice denoting excess payment of tax (if any) ........................................................................ 7. Details of payments made: Challan Number Date Amount 1. ................................................................. ................................................................. ................................................................. 2. ................................................................. ................................................................. ................................................................. 8. Amount of Final Demand ........................................................................................................................................................................................ 9. Amount of Refund Claimed ........................................................................................................................................................................................ 10. Manner of Refund Preferred Payment Order Payable at Treasury Adjustment Order 11. If refund by adjustment is preferred, mention the period against which adjustment is prayed ..................................................................................................................................... 12. Grounds of Refund ..................................................................................................................................................................................................................... ............................................................................................................................................................................................................................................................................................ DECLARATION I, ..........................................................................................., the petitioner, named in the above petition, do hereby declare that what is stated herein is true to the best of my knowledge and belief and that no application for refund of the above amount has been made by me or on my behalf before this date. Place ................................................... Signature ................................................................................ Date ................................................... Designation ................................................................................
