Kotwani's Value Added Tax 1"FORM VAT - 22 [See Rule 29(1)] Application for refund by a person or unregistered dealer To 1. Name of Person or Dealer 2. Address No/ Area/ locality Town/City District (State) Alternate e-mail Id 3.1 Name of the Bank in which refund is sought 3.2 Name of the Branch 3.3 Account No. 3.4 Account Type 3.5 IFSC No. of Branch 4. Amount of Refund claimed (Rs.) ________________________________________________ 5. Reason(s) for refund ________________________________________________ a. Result of an order passed (give details) i. Period From ii. Date of order DD/MM/YYYY b. As a result of order of competent officer/authority/court i. Name of Authority ii. Date of order DD/MM/YYYY Place : Signature Date : Name: Status Verification I certify that the above information and its enclosures (if any) are true and correct to the best of my knowledge and belief and nothing has been concealed Place : Signature Date : Full Name: Status 1. Substituted by clause 9 of the Rajasthan Value Added Tax (Eighth Amendment) Rules, 2008 w.e.f. 30.08.2008 318 The Rajasthan Value Added Tax Forms Instructions 1. Please read the instructions carefully. 2. All the entries should be filled in capital letters. 3. Tick 9 applicable in option boxes. 4. Please ensure that the form is complete. 5. 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. 6. Enclose original copies of VAT invoices. 7. Enclose copy of contract (in case of contractors). 8. Wherever applicable, attach copy of documents (in support that you are not liable to tax)." 319
