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FORM GST RFD-10 B
[See rule 95A]
Application for refund by Duty Free Shops/Duty Paid Shops (Retail
outlets)
1. GSTIN:
2. Name:
3. Address:
4. Tax Period (Monthly/Quarterly) : From <DD/MM/YY>To<DD/MM/YY>
5. Amount of Refund Claim:
<INR><In Words>
6. Details of inward supplies of goods received and corresponding
outward supplies:
|
DETAILS OF
SUPPLIES |
|
Inward Supplies |
Corresponding
outward supplies |
|
GSTIN of supplier |
Invoice details |
Rate |
Taxable value |
Amount of tax |
Invoice details |
|
No / Date. |
HSN Code |
Qty. |
Value |
Integrated Tax |
Central Tax |
State /UT Tax |
Cess |
No./ Date |
HSN Code |
Qty. |
Taxable Value |
7. Refund applied for:
|
Central Tax |
State/UT Tax |
Integrated Tax |
Cess |
Total |
| |
|
|
|
|
| |
|
|
|
|
|
<Total> |
<Total> |
<Total> |
<Total>
|
<Total>
|
8. Details of Bank Account:
i. Bank Account Number
ii. Bank Account Type
iii. Name of the Bank
iv. Name of the Account Holder/Operator
v. Address of Bank Branch
vi. IFSC
vii. MICR
9. Declaration:
I _______ as an authorized
representative of ___________(Name of Duty Free Shop/Duty Paid Shop –
retail outlet) hereby solemnly affirm and declare that,-
(i) refund has not been
claimed against any of the invoices in respect of outward supplies
submitted with this application.
(ii) the information given herein above is true and correct to the best
of my knowledge and belief.
Date:
Signature of Authorized Signatory:
Place:
Name:
Designation / Status
Instructions:
1. Application for refund
shall be filed on monthly/quarterly basis depending upon the frequency
of furnishing of return by retail outlets.
2. Application shall be made in respect of one inward supply invoice
only once. Therefore, it is advised that refund shall be applied only
for those inward supply invoices the goods received against which have
been completely supplied.
3. Applicant should ensure that all the invoices declared by him have
the GSTIN of the supplier and the GSTIN of the respective Duty Free Shop
/Duty Paid Shop (retail outlet) clearly marked on them.
4. Documents to be attached with the refund application:
a) Undertaking that all indigenous goods on which refund is being claimed
have been received by the Duty-Free Shop/Duty Paid Shop (retail outlet);
b) Undertaking that the indigenous goods have been sold to eligible
outgoing international tourist;
c) Copy of the returns for the period for which application is being
filed. |