Signature
Name –
Designation / Status?]
DECLARATION [section 54(3)(ii)]
I hereby declare that the refund of input tax credit 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 89(2)(f)]
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
DECLARATION [rule 89(2)(g)]
(For recipient/supplier of deemed export)
In case refund claimed by recipient
I hereby declare that the refund has been claimed only for those invoices which have been detailed in statement 5B for the tax period for which refund is being claimed and the amount does not exceed the amount of input tax credit availed in the valid return filed for the said tax period. I also declare that the supplier has not claimed refund with respect to the said supplies.
In case refund claimed by supplier
I hereby declare that the refund has been claimed only for those invoices which have been detailed in statement 5B for the tax period for which refund is being claimed. I also declare that the recipient shall not claim any refund with respect of the said supplies and also, the recipient has not availed any input tax credit on such supplies. Signature
Name –
Designation / Status
UNDERTAKING
I hereby undertake to pay back to the Government the amount of refund sanctioned along with interest in case it is found subsequently that the requirements of clause (c) of sub-section
(2) of section 16 read with sub-section (2) of section 42 of the CGST/SGST Act have not been complied with in respect of the amount refunded.
Signature
Name –
Designation / Status
< between adjusted annual taxable turnover as
derived from Table 7E above and the taxable turnover declared in Table 7F
shall be specified here.
Part III consists of reconciliation of the tax payable as per declaration in the reconciliation statement and the actual tax paid as declared in Annual Return (GSTR9). The instructions to fill this part are as follows :-
Table No.
|
Instructions
|
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|
9
|
The table provides for reconciliation of tax paid as per reconciliation statement
|
|
and amount of tax paid as declared in Annual Return (GSTR 9). Under the
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|
head labelled ?RC?, supplies where tax was paid on reverse charge basis by
|
|
the recipient (i.e. the person for whom reconciliation statement has been
|
|
prepared) shall be declared.
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9P
|
The total amount to be paid as per liability declared in Table 9A to 9O is auto
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|
populated here.
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9Q
|
The amount payable as declared in Table 9 of the Annual Return (GSTR9)
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shall be declared here. It should also contain any differential tax paid on Table
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&nb
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H
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of transactions specified
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in A to F above (-)
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Pt.
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V
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Auditor's recommendation on additional Liability due to non-reconciliation
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To be paid through Cash
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As per section 17(5)
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10 or 11 of the Annual Return (GSTR9).
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10
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Reasons for non-reconciliation between payable / liability declared in Table
|
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9P above and the amount payable in Table 9Q shall be specified here.
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11 Any amount which is payable due to reasons specified under Table 6, 8 and 10 above shall be declared here.
- Part IV consists of reconciliation of Input Tax Credit (ITC). The instructions to fill Part IV are as under:-
Table No.
|
Instructions
|
|
|
12A
|
ITC availed (after reversals) as per the audited Annual Financial Statement
|
|
shall be declared here. There may be cases where multiple GSTINs (State-
|
|
wise) registrations exist on the same PAN. This is common for persons /
|
|
entities with presence over multiple States. Such persons / entities, will have
|
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to internally derive their ITC for each individual GSTIN and declare the same
|
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here. It may be noted that reference to audited Annual Financial Statement
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includes reference to books of accounts in case of persons / entities having
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Amendments (+) (net of debit
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notes)
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Supplies / tax (outward) reduced
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12
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through
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Amendments (-) (net of credit
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notes)
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presence over multiple States.
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12B
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Any ITC which was booked in the audited Annual Financial Statement of
|
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earlier financial year(s) but availed in the ITC ledger in the financial year for
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which the reconciliation statement is being filed for shall be declared here.
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This shall include transitional credit which was booked in earlier years but
|
|
availed during Financial Year 2017-18.
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12C
|
Any ITC which has been booked in the audited Annual Financial Statement of
|
|
the current financial year but the same has not been credited to the ITC ledger
|
|
for the said financial year shall be declared here.
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12D
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ITC availed as per audited Annual Financial Statement or books of accounts
|
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as derived from values declared in Table 12A, 12B and 12C above will be
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tax
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E
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Deemed Exports
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Advances on which tax has
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F
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been paid but invoice has not
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(c)
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Exports of goods / services- without payment of tax (accumulated ITC)
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down)
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(d)
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ITC accumulated due to inverted tax structure [under clause (ii) of first
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proviso to section 54(3)]
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(e)
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On account of supplies made to SEZ unit/ SEZ developer (with
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payment of tax)
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F
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Reversal of TRAN-I credit
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G
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Others
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f)
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5 |
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6
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7
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8
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9
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10
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11
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12
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>
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">A |
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Reason 1
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<<Text>>
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B
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Reason 2
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<<Text>>
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C
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Reason 3
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<<Text>>
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persons (B2B)
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Zero rated supply (Export) on
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C
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payment of tax (except
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(f) On account of supplies made to SEZ unit/ SEZ developer (without payment of tax)
/td>Authority
(g) Recipient of deemed export supplies/ Supplier of deemed export
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supplies
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(h)
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On account of order
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Sl.
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Type of order
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Order
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Order
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Order
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Payment
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No.
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No.
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date
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Issuing
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reference
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and ITC availed
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E
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Import of goods (including
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Inputs
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supplies to SEZs)
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D
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Supply to SEZs on payment of
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A
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Reason 1
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<<Text>>
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B
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Reason 2
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<<Text>>
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C
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Reason 3
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Description
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Taxable Value
|
Centra
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State
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Integrat
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Cess
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supplies from SEZs)
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Capital Goods
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F
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Import of services (excluding inward supplies
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from SEZs)
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no., if any
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(i)
|
Assessment
|
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l Tax
|
|
Tax /
|
ed Tax
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UT
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Tax
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1
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2
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3
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|
4
|
5
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6
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|
Supplies / tax declared
|
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|
10
|
|
through Amendments (+) (net
|
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|
of debit notes)
|
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|
Supplies / tax reduced through
|
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|
11
|
|
Amendments (-) (net of credit
|
|
|
|
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|
|
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|
|
|
|
|
|
notes)
|
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|
12
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<<Text>>
|
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|
Tax payable on un-reconciled difference in ITC (due to reasons specified in 13
|
|
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|
16
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and 15 above)
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Description
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Amount Payable
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Central Tax
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State/UT
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> |
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K
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|
revisions if any)
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L
|
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Transition Credit through TRAN-II
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M
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Any other ITC availed but not specified above
|
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N
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|
Statement-5A [rule 89(4)]
Refund Type: On account of supplies made to SEZ unit / SEZ developer without payment of tax (accumulated ITC) – calculation of refund amount
|
|
|
(Amount in Rs.)
|
|
|
|
|
|
Turnover of zero rated
|
Net input tax
|
Adjusted total
|
|
Refund amount
|
supply of goods and
|
credit
|
turnover
|
|
(1×2÷3)
|
services
|
|
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|
|
Statement 5B [rule 89(2)(g)]
Refund Type: On account of deemed exports
(Amount in Rs)
Sl.
|
Details of invoices of outward
|
|
|
Tax paid
|
|
No.
|
su>
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|
;
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Refund
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F
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ITC available but ineligible
|
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IGST paid on import of goods (including
|
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G
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supplies from SEZ)
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by supplier/Details of invoices of
|
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|
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inward supplies in case refund is
|
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|
claimed by recipient
|
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|
GSTIN
|
|
No.
|
Date
|
Taxable
|
Integrated
|
Central
|
|
State Tax /Union
|
Cess
|
|
of the
|
|
|
|
Value
|
Tax
|
Tax
|
|
Territory Tax
|
|
|
supplier
|
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|
1
|
2
|
|
3
|
4
|
5
|
6
|
7
|
|
8
|
9
|
|
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|
|
Statement-6 [rule 89(2)(j)]
Refund Type: On account of change in POS (inter-State to intra-State and vice versa)
d valign="bottom" width="7">
Order Details (issued in pursuance of sections 77(1) and 77(2), if any:
|
|
|
|
|
Oign="bottom" width="57">
|
(ii)
|
Finalization
|
of
|
|
|
|
|
|
|
|
Provisional
|
|
|
|
|
|
|
|
|
assessment
|
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|
|
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|
|
(iii)
|
Appeal
|
|
|
|
|
|
|
<stsp;
G
pending
out of E
above
16
Details of credit reversed or availed
Description
Centra
State
Integrate
Cess
l Tax
Tax /
d Tax
UT
Tax
1
2
3
4
5
Credit reversed on opting in the composition
A
scheme (-)
Credit availed on opting out of the
&"bottom" width="8">
|
|
Sub-total (K to M above)
|
|
|
|
|
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|
O
|
|
|
Total ITC availed (I + N above)
|
|
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|
&n
|
|
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|
Tax
|
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|
Integrated
|
|
|
|
|
|
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|
|
(Amount in Rs.)
|
|
|
|
|
|
|
|
|
Sr. No.
|
|
Invoice details
|
|
Goods/
|
Shipping bill/ Bill of export/
|
|
|
|
|
|
Services (G/S)
|
|
|
|
|
|
|
|
Order Date:
|
|
|
|
|
|
|
|
|
|
|
|
|
(Amount in Rs.)
|
|
|
Reversal of TRAN-II credit
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
H
|
|
|
Other reversals (pl. specify)
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
I
|
|
|
Total ITC Reversed (Sum of A to H above)
|
|
|
|
|
|
|
|
|
|
|
|
|
|
J
|
|
|
Net ITC Available for Utilization (6O - 7I)
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Central
|
|
|
State tax
|
|
|
Integrated tax
|
|
|
Cess, if
|
Demand
Tax
Interest
Penalty
Other
Total
(Name of State /
UT)
1
2
3
4
5
6
7
Amount in dispute
/ earlier order
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been issued (not covered under
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(A) to (E) above)
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auto-populated here.
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12E
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Net ITC available for utilization as declared in Table 7J of Annual Return
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(GSTR9) shall be declared here.
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13
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Reasons for non-reconciliation of ITC as per audited Annual Financial
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Statement or books of account (Tablenter">Endorsed invoice no.
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No.
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Date
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Value
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No.
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Date
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1
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2
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3
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4
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5
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6
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7
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Statement-5A [rule 89(4)]
Refund Type:On account of supplies made to SEZ unit / SEZ developer without payment of tax (accumulated ITC) – calculation of refund amount
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(Amount in Rs.)
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Turnover of zero rated
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Net input tax
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Adjusted total
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Refund amount
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supply of goods and
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credit
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turnover
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(1×2÷3)
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services
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1
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2
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3
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4
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Statement 5B [rule 89(2)(g)]
Refund Type: On account of deemed exports
(Amount in Rs)
Sl.
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Details of invoices of outward
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Tax paid
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No.
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supplies in case refund is claimed
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availed in the Annual Return (GSTR9) shall be specified here.
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14
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This table is for reconciliation of ITC declared in the Annual Return (GSTR9)
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against the expenses booked in the audited Annual Financial Statement or
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books of account. The various sub-heads specified under this table are general
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expenses in the audited Annual Financial Statement or books of account on
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which ITC may or may not be available. Further, this is only an indicative list
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of heads under which expenses are generally booked. Taxpayers may add or
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delete any of these heads but all heads of expenses on which GST has been
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paid / was payable are to be declared here.
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14R
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Total ITC declared in Table 14A to 14Q above shall be auto populated here.
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14S
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Net ITC availed as declared in the Annual Return (GSTR9) shall be declared
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Determined
Amount
Place:
Date:
Signature:
Name of the Appellate Authority / Revisional
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Authority/ Tribunal / Jurisdictional Officer
Designation:
Jurisdiction:
[F.No.20/06/16/2018-GST]
(Dr. Sreeparvathy S.L.)
Under Secretary to the Government of India
Note:- The principal rules were published in the Gazette of India, Extraordinary, Part II, Section 3, Sub-section (i) vide notification No. 3/2017-Central Tax, dated the 19th June,2017, published vide number G.S.R 610 (E), dated the 19th June, 2017 and last amended vide notification No. 60/2018 - Central Tax, dated the 30th October, 2018, published vide number G.S.R 1075 (E), dated the 30th October, 2018.
rong>SELF- DECLARATION [rule 89(2)(l)]
I ____________________ (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.
Signature
Name –
Designation / Status
(This Declaration is not required to be furnished by applicants, who are claiming refund under clause (a) or clause (b) or clause (c) or clause (d) or clause (f) of sub-section (8) of section 54.)
- 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.
I/We declare that no refund on this account has been received by me/us earlier.
Place
Date
Signature of Authorised Signatory
(Name)
Designation/ Status
Annexure-1
Statement -1 [rule 89(5)]
Refund Type: ITC accumulated due to inverted tax structure [clause (ii) of first proviso to section 54(3)]
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(Amount in Rs.)
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Turnover of
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Tax payable
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Adjusted
|
Net input tax
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Maximum refund
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(iv)
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Any other order
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(specify)
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Reason 2
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<<Text>>
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C
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Reason 3
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bottom" width="8">
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Description
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Value
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tax
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/ UT tax
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applicable
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Recipients‘
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Invoice details
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Details of tax paid on transaction
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Taxes re-assessed on transaction
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GSTIN/
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considered as intra –State / inter-State
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which were held inter State / intra-
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UIN
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transaction earlier
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State supply subsequently
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Name
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Integrated
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Central
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State/CessPlace
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Integrated
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Central
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State/CessPlace
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(in case
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tax
|
tax
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UT
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of
|
tax
|
tax
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UT
9">
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by supplier/Details of invoices of
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inward supplies in case refund is
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claimed by recipient
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GSTIN
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No.
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Date
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Taxable
|
Integrated
|
Central
|
State Tax /Union
|
Cess
|
|
of the
|
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Value
|
Tax
|
Tax
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Territory Tax
|
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supplier
|
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1
|
2
|
|
3
|
4
|
5
|
6
|
7
|
8
|
9
|
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<<Text>>
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11
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Additional amount payable but not paid (due to reasons specified under Tables
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6,8 and 10 above)
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here. Table 7J of the Annual Return (GSTR9) may be used for filing this
|
|
Table.
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15 Reasons for non-reconciliation between ITC availed on the various expenses declared in Table 14R and ITC declared in Table 14S shall be specified here.
16 Any amount which is payable due to reasons specified in Table 13 and 15 above shall be declared here.
- Part V consists of the auditor‘s recommendation on the additional liability to be discharged by the taxpayer due to non-reconciliation of turnover or non-reconciliation of input tax credit. The auditor shall also recommend if there is any other amount to be paid for supplies not included in the Annual Return. Any refund which has been erroneously taken and shall be paid back to the Government shall also be declared in this table. Lastly, any other outstanding demands which is recommended to be settled by the auditor shall be declared in this Table.
- Towards the end of the return, taxpayers shall be given an option to pay any additional liability declared in this form, through FORM DRC-03. Taxpayers shall select
?Reconciliation Statement? in the drop down provided in FORM DRC-03. It may be noted that such liability shall be paid through electronic cash ledger only.
PART – B- CERTIFICATION
- I. &nbs>
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Inward supplies on which tax
|
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|
|
|
|
|
G
|
|
|
is to be paid on reverse charge
|
|
|
|
|
|
|
|
|
|
|
|
|
|
basis
|
|
|
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|
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|
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|
H
|
|
|
Sub-total (A to G above)
|
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|
" width="56">
|
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Inward supplies liable to reverse
|
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|
|
|
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|
13
|
|
|
charge reduced through
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Amendments (-) (net of credit
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
of
|
B2C)
|
|
No.DateValueTaxable
|
|
|
tax
|
|
Supply
|
|
|
tax
|
|
Supply
|
|
|
|
Value
|
|
|
|
|
|
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|
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|
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|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
1
|
|
|
2
|
|
3
|
|
4
|
|
|
|
5
|
|
6
|
|
5%
12%
18%
28%
3%
0.25%
0.10%
Input Tax
Credit
Interest
Late Fee
Penalty
Any other
amount paid
for supplies
not included
in Annual
Return
(GSTR 9)
Erroneous
refund to be
paid back
Outstanding
demands to
be settled
Other (Pl.
|