Kotwani's Value Added Tax 1"FORM VAT - 23A [See Rule 27(1)(a), 28(3) & 29(2)] Form For Electronic Refund To The Manager, State Bank of Bikaner and Jaipur Please transfer the amount of Rs. (in words) ________________________________________________ (in figures)______________________________________________ to M/s (name and address of the dealer) _______________________________________________________ having TIN _________________ in the account, the details of which are as under: 1. Name of the Bank:__________________________ 2. Name of the Branch :________________________ 3. Account No: _____________________________ 4. Account Type:_____________________________ 5. MICR code of branch:_______________________ on account of refund for the period _____________ to ______________ Certified that the refund has been entered at S. No. ________________ of Demand and Collection register for the year _______________ and that the tax, penalty, or interest concerning which the refund is given has been credited in the Bank/ treasury vide challan No. ____________________ dated ______________ and entered in R.C.R. at S. No. _______________________________. Certified that no refund order regarding the sum now in question has previously been granted and this order of refund has been entered in the file of M/s ___________________________ for the period _______________________ under my signature. Seal of the office Signature of Issuing Authority Name of Issuing Authority Copy to the Treasury Officer, _________________ treasury with a request to adjust the amount in the Treasury under VAT Deduct Refunds. Seal of the office Signature of Issuing Authority Name of Issuing Authority" 1. Inserted by clause 10 of the Rajasthan Value Added Tax (Eighth Amendment) Rules, 2008 w.e.f. 30.08.2008 320 The Rajasthan Value Added Tax Forms Verification I verify that the above information and its enclosures is true and correct to the best of my knowledge and belief and nothing has been concealed Place : Signature Date : Name : Status For office use only Determination of Tax by the AC/CTO Rs. Security submitted Rs. Final action taken _______________________________________________________________ Signature of AC/CTO ____________________________________________________________ 321
