Applicaion No
1. Name of the organization
2. Address
3. Period to which the claim relates
From
To
4. Amount of Refund Claimed
5. Details of purchase on which refund claimed
QuarterBill No./Retail Invoice No.TIN/SRINName of the dealer from whom purchasedAddress of the dealer from whom purchasedDescription of goodsQuantityUnitsValue of goods excluding VATVAT paid  
Update Delete
Total.Text
0
0
Update Delete
6. Bank details in which the refund claimed will be credited (if approved only)
Bank Name
A/C Holder Name (to which the amount will be credited)
A/C No
A/C Type
IFSC Code
MICR Code
Branch Name
7. Details of the Officer authorized to apply for refund
Email
Mobile No
            
   
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