GOVERNMENT OF JHARKHAND COMMERCIAL TAXES DEPARTMENT [See Rule 19(2)(c), 20(1), 21(3)] Application for Refund for others Cover Page 1. Name of Person(s) / Foreign Diplomatic Missions/U.N. Bodies___________________ 2. Registration No. (TIN), if any__________________________________ 3. Address Building Name/Number ___________________________ Area/Road ___________________________ Locality/Market ___________________________ Pin Code ___________________________ Email Id ___________________________ Telephone Number(s) ___________________________ Fax Number(s) ___________________________ 4. Details of purchases for which refund is claimed: 5. Reason for refund____________________________________________________________________ Invoice Description of goods/ Transaction Quantity Value Tax paid (Rs. Name of Dealer Registration No. (TIN) Number Date Verification I certify that the information given in this form and its attachments (if any) is true and correct to the best of my knowledge and belief and nothing has been concealed Signature Full name of Applicant Designation Date Place Instructions : 1. Please ensure that the form is complete 2. This Form should be verified and signed by: a. Proprietor, in case of Proprietorship concern b. Managing Partner, in case of Partnership firm and where there is no Managing Partner, by all the partners if there is no registered partnership deed and in case of a registered partnership deed by any one of them. c. Managing Director or authorized signatory, in case of a Company d. Karta, in case of Hindu Undivided Family e. Authorised Signatory, in all other cases 4. Enclose original copies of VAT invoices/or certificate of Deduction of Tax at source, and evidence of payment of such Tax in Government Treasury. 5. Enclose copy of contract (in case of contractors)
