FORM-GST-RFD-01

[See rule       ]

Application for Refund

Select: Registered / Casual/ Unregistered/Non-resident taxable person

1. GSTIN/Temporary ID:
2. Legal Name:
3. Trade Name, if any:
4. Address:
5. Tax Period:                   From <DD/MM/YY>                To <DD/MM/YY>

• Amount of Refund Claimed:

Act	Tax	Interest	Penalty	Fees	Others	Total
Central Tax
State Tax
UT Tax
Integrated Tax
Cess
Total

• Grounds of Refund Claim: (select from the drop down):
  • Excess balance in Electronic Cash ledger
  • Exports of goods / services- With payment of Tax
  • Exports of goods / services- Without payment of Tax, i.e., ITC accumulated
  • On account of assessment/provisional assessment/ appeal/ any other order
    • Select the type of Order:

Assessment/ Provisional Assessment/ Appeal/ Others

1. Mention the following details:
   1. Order No.
      1. Order Date <calendar>
      1. Order Issuing Authority
      1. Payment Reference No. (of the amount to be claimed as refund)

(If Order is issued within the system, then 2, 3, 4 will be auto populated)

• ITC accumulated due to inverted tax structure (clause (ii) of proviso to section 54(3)
  • On account of supplies made to SEZ unit/ SEZ Developer or Recipient of Deemed Exports
    • Select the type of supplier/ recipient:

1. Supplier to SEZ Unit
   1. Supplier to SEZ Developer
      1. Recipient of Deemed Exports
   1. Tax paid on a supply which is not provided, either wholly or partially, and for which invoice has not been issued
   1. Tax paid on an intra-State supply which is subsequently held to be inter-State supply and vice versa
   1. Excess payment of tax, if any
   1. Any other (specify)
2. Details of Bank Account (to be auto populated from RC in case of registered taxpayer)
   1. Bank Account Number              :
   1. Name of the Bank                     :
   1. Bank Account Type                   :
   1. Name of account holder             :
   1. Address of Bank Branch            :
   1. IFSC                                        :
   1. MICR                                       :

• Whether Self-Declaration filed by Applicant u/s 54(4), if applicable Yes No

DECLARATION (Rule…)

I hereby declare that the goods exported are not subject to any export duty. I also declare that I have not availed any drawback on goods or services or both and that I have not claimed refund of the integrated tax paid on supplies in respect of which refund is claimed.

Signature Name –

Designation / Status

DECLARATION (Rule…)

I hereby declare that the refund of ITC claimed in the application does not include ITC availed on goods or services used for making nil rated or fully exempt supplies.

Signature Name –

Designation / Status

DECLARATION (Rule…)

I hereby declare that the Special Economic Zone unit /the Special Economic Zone developer has not availed of the input tax credit of the tax paid by the applicant, covered under this refund claim.

Signature Name –

Designation / Status

SELF- DECLARATION

I/We                                        (Applicant) having GSTIN/ temporary Id                           ,

solemnly affirm and certify that in respect of the refund amounting to Rs———————————————————————————– / with

respect to the tax, interest, or any other amount for the period from—to———————————————————————————— ,

claimed in the refund application, the incidence of such tax and interest has not been passed on to any other person.

(This Declaration is not required to be furnished by applicants, who are claiming

refund under sub rule<> of the GST Rules<…>.)

1. Verification

I/We <Taxpayer Name> hereby solemnly affirm and declare that the information given herein above is true and correct to the best of my/our knowledge and belief and nothing has been concealed therefrom.

We declare that no refund on this account has been received by us earlier.

Place                                                                                     Signature of Authorized

Signatory

Date                                                                                       (Name)

Designation/ Status

Note: 1) A separate statement has to be filed under sub-rule (4) of rule 1 of draft Goods and Services Tax refund

Statement 1:

(Note: – All statements are auto populated from the corresponding returns taxpayer have to select the invoices accordingly and fields like egm/ebrc to be filled if the same was not filled in the return)

Statement in case of Application under Rule 1 sub rule 2 (g):

Annexure-1

Statement containing the number and date of invoices under <…>of GST Rules,

For Inward Supplies:

As per GSTR- 2 (Table 4):

Tax Period: ……

GSTIN/ Name of unregistered supplier	Invoice details	State (in case of unregistered supplier)	Integrated Tax	Central Tax	State Tax/ UT Tax	CESS	Col. 17	Col. 18	Col. 19	Col. 20/21/22/23
No	Date	Value	Goods/ Services (G/S)	HSN/ SAC	Taxable value	UQC	QTY	Rate (%)	Amt.	Rate (%)	Amt.	Rate (%)	Amt.	Rate (NA)	Amt.	Integrated Tax	Central Tax	State Tax/ UT Tax	Cess
1	2	3	4	5	6	7	24A	24B	8	9	10	11	12	13	14	15	16	17	18	19	20	21	22	23

Col. 17: POS (only if different from the location of recipient) Col. 18: Indicate if supply attracts reverse charge (Yes / No)

Col. 19: Eligibility of ITC as (inputs/capital goods/input services/ none) Col. 20/21/22/23: Amount of ITC available

For Outward Supplies:

As per GSTR- 1 (Table 5):

Tax Period: ……

GSTIN/ UIN	Invoice details	Integrated Tax	Central Tax	State Tax/ UT Tax	Cess	Col. 16	Col. 17	Col. 18	Col. 19	Col. 20	Col. 21	Col. 22
No.	Date	Value	Goods/ services (G/S)	HSN/ SAC	Taxable Value	UQC	QTY	Rate (%)	Amt	Rate (%)	Amt	Rate (%)	Amt	Rate (NA)	Amt
1	2	3	4	5	6	7	23A	23B	8	9	10	11	12	13	14	15	16	17	18	19	20	21	22

Col. 16: POS (only if different from the location of recipient)

Col. 17: Whether supply made to SEZ / SEZ developer (Yes / No)

Col. 18: Tax option for supplies made to SEZ / SEZ developer (With Integrated Tax/ Without Integrated Tax) Col. 19: Deemed Exports (Yes/No)

Col. 20: whether supply attracts reverse charge (Yes / No)

Col. 21: Whether tax on this invoice is paid on provisional basis (Yes /No) Col. 22: GSTIN of e-commerce operator (if applicable)

Place                                                                                  Signature of Authorized Signatory

Date                                                                                     (Name)

Designation/ Status

Statement 2:

Statement in case of Application under Rule 1 sub rule 2 (b) and (c): Exports with payment of Tax:

Tax Period: ……

Invoice

Shipping bill/ Bill of export

Tax payment option

Integrated Tax

Whether tax on this invoice is paid on provisional basis (Yes /No)

EGM Details

BRC/ FIRC

No.

Date

Value

Goods/ Services (G/S)

HSN/ SAC

UQC

QTY

Taxable value

Port Code

No.

Date

With Integrated Tax

Without Integrated Tax

Rate (%)

Amt.

Ref No.

Date

No.

Date

1

2

3

4

5

15A

15B

6

7

8

9

10

11

12

13

14

15C

15D

15E

15F

(* Shipping Bill and EGM are mandatory; – in case of goods; BRC/ FIRC details are mandatory– in case of Services)

Place                                                                                  Signature of Authorized Signatory

Date                                                                                     (Name)

Designation/ Status

Statement 3:

Exports without payment of Tax:

Tax Period: ……

Invoice

Shipping bill/ Bill of export

Tax payment option

Integrated Tax

Whether tax on this invoice is paid on provisional basis (Yes /No)

EGM Details

BRC/ FIRC

No.

Date

Value

Goods/ Services (G/S)

HSN/ SAC

UQC

QTY

Taxable value

Port Code

No.

Date

With Integrated Tax

Without Integrated Tax

Rate (%)

Amt.

Ref No.

Date

No.

Date

1

2

3

4

5

15A

15B

6

7

8

9

10

11

12

13

14

15C

15D

15E

15F

(* Shipping Bill and EGM – in case of goods are mandatory; BRC/ FIRC details are mandatory– in case of Services)

Place                                                                                  Signature of Authorized Signatory

Date                                                                                     (Name)

Designation/ Status

Statement 4:

Statement in case of Application under Rule 1 sub rule 2 (d) and (e): Refund by the supplier of SEZ/ Developer:

GSTR- 1 Table 5

Tax Period: ……

GSTIN/ UIN

Invoice details

Integrated Tax

Central Tax

State Tax/ UT Tax

Cess

Col. 16

Col. 17

Col. 18

Col. 19

Col. 20

Col. 21

Col. 22

ARE

Date of Receipt

Payment Details

No.

Date

Value

Goods/ services (G/S)

HSN/ SAC

Taxable Value

UQC

QTY

Rate (%)

Amt

Rate (%)

Amt

Rate (%)

Amt

Rate (NA)

Amt

No.

Date

Ref No.

Date

1

2

3

4

5

6

7

23A

23B

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23C

23D

23E

23F

23G

Col. 16: POS (only if different from the location of recipient)

Col. 17: Whether supply made to SEZ / SEZ developer (Yes / No)

Col. 18: Tax option for supplies made to SEZ / SEZ developer (With Integrated Tax/ Without Integrated Tax) Col. 19: Deemed Exports (Yes/No)

Col. 20: whether supply attracts reverse charge (Yes / No)

Col. 21: Whether tax on this invoice is paid on provisional basis (Yes /No) Col. 22: GSTIN of e-commerce operator (if applicable)

Col. 23 C/D: ARE (Application for Removal of Export)

Col. 23 E: Date of receipt by SEZ/ Developer (as per re warehousing certificate)

Col. 23 F/G: Particulars of Payment Received

(* In case of Goods: ARE and Date of Receipt by SEZ/ Developer are mandatory; In case of Services: Particulars of Payment Received is mandatory)

GSTR 5- Table 6

Tax Period: ……

Col. 1

Invoice details

Integrated Tax

Central Tax

State Tax/ UT Tax

Cess

Col. 16

Col. 17

Col. 18

Col. 19

Col. 20

ARE

Date of Receipt

Payment Details

No.

Date

Value

Goods/ Services (G/S)

HSN/ SAC

UQC

QTY

Taxable Value

Rate (%)

Amt.

Rate (%)

Amt.

Rate (%)

Amt.

Rate (NA)

Amt.

No.

Date

Ref No.

Date

1

2

3

4

5

6

21A

21B

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21C

21D

21E

21F

21G

Col. 1: GSTIN / UIN/ Name of the un registered recipient (Supplier to SEZ/ Developer) Col. 16: POS (only if different from the location of recipient)

Col. 17: Whether supply made to SEZ / SEZ developer (Yes / No)

Col. 18: Tax option for supplies made to SEZ / SEZ developer (With Integrated Tax/ Without Integrated Tax) Col. 19: Deemed Exports (Yes/No)

Col. 20: Whether tax on this invoice is paid on provisional basis (Yes /No) Col. 21 C/D: ARE (Application for Removal of Export)

Col. 21 E: Date of receipt by SEZ/ Developer (as per re warehousing certificate)

Col. 21 F/G: Particulars of Payment Received

(* In case of Goods: ARE and Date of Receipt by SEZ/ Developer are mandatory; In case of Services: Particulars of Payment Received is mandatory)

Place                                                                                  Signature of Authorized Signatory

Date (Name)

Designation/ Status

Statement 5:

Statement in case of Application under Rule 1 sub rule 2 (d) and (e): Refund by the EOU/ Recipient of Deemed Exports:

Tax Period: ……

GSTIN/ Name of unregistered supplier

Invoice details

State (in case of unregistered supplier)

Integrated Tax

Central Tax

State Tax/ UT Tax

CESS

Col. 17

Col. 18

Col. 19

Col. 20/21/22/23

ARE

Date of Receipt

No

Date

Value

Goods/ Services (G/S)

HSN/ SAC

Taxable value

UQC

QTY

Rate (%)

Amt.

Rate (%)

Amt.

Rate (%)

Amt.

Rate (NA)

Amt.

Integrated Tax

Central Tax

State Tax/ UT Tax

Cess

No.

Date

1

2

3

4

5

6

7

24A

24B

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24C

24D

24E

Col. 17: POS (only if different from the location of recipient) Col. 18: Indicate if supply attracts reverse charge (Yes / No)

Col. 19: Eligibility of ITC as (inputs/capital goods/input services/ none) Col. 20/21/22/23: Amount of ITC available

Col. 24 C/D: ARE (Application for Removal of Export)

Col. 24 E: Date of receipt by SEZ/ Developer (as per re warehousing certificate)

(* In case of Goods: ARE and Date of Receipt are mandatory)

Place                                                                                  Signature of Authorized Signatory

Date                                                                                     (Name)

Designation/ Status

Statement 6:

Statement in case of Application filed under Rule 1(2)(j) [Refund u/s 77(1) & 77(2) -Tax wrongfully collected and paid ]

Order Details (issued in pursuance of Section 77 (1) and (2):                                                                                                   Order No:                                                                                                   Order Date:

GSTIN/ UIN

Details of invoice covering transaction considered as intra –State / inter-State transaction earlier

Transaction which were held inter State / intra-State supply subsequently

Name

(in case B2C)

Invoice details

Integra ted Tax

Central Tax

State Tax

Cess

Place of Supply (only if different from the location

Integrated Tax

Central Tax

State Tax

Cess

Place of Supply (only if different from the location

No.

Date

Value

Taxable

Amt

Amt

Amt

Amt

of recipient)

Amt

Amt

Amt

Amt

of recipient)

Value

1

2

3

4

5

6

7

8

10

11

12

13

14

15

16

Statement 7:

Statement in case of application filed under Rule 1(2)(k) Refund on account excess payment of tax

Sr. No.	Tax period	Reference no. of return	Date of filing return	Excess amount available in Liability Register
Integrated Tax	Central Tax	State Tax	Cess
1	2	3	4	5	6	7	8

Annexure-2 [See Rule …] Certificate

This is to certify that in respect of the refund amounting to INR <<  >>——————————————————————————————- (in words) claimed by

M/s —————– (Applicant’s Name) GSTIN/ Temporary ID——- for the tax period <   >, the incidence

of tax and interest, has not been passed on to any other person. This certificate is based on the examination of the Books of Accounts, and other relevant records and Returns particulars maintained/ furnished by the applicant.

Signature of the Chartered Accountant/ Cost Accountant:

Name:

Membership Number:

Place:

Date:

This Certificate is not required to be furnished by the applicant, claiming refund under clause (a) or clause (b) or clause (c) or clause (d) or clause (f) of sub-section (8) of section 54 of the Act.