FORM GST RFD-10A

FORM GST RFD-10A
(See Rule 95)
Application for refund by Canteen Stores Department (CSD)

1. GSTIN :

2. Name :

3. Address :

4. Tax Period (Quarter) : From <DD/MM/YY>To <DD/MM/YY>

5. Amount of Refund Claim : <INR><In Words>

6. Details of inward supplies of goods received:

GST IN of supplier	Invoice/Debit Note/Credit Note details			Rate	Taxable value	Taxable value
GST IN of supplier	No.	Date	Value	Rate	Taxable value	Integrated tax	Central Tax	State/ Union territory Tax
1	2	3	4	5	6	7	8	9
6A. Invoices received
To
6B. Debit/Credit Note received
a l

refund applied for:

Central Tax	State /Union territory Tax	Integrated Tax	Total


<Total>	<Total>	<Total>	<Total>

8. Details of Bank Account:
    a. Bank Account Number
    b. Bank Account Type
    c. Name of the Bank
    d. Name of the Account Holder
    e. Address of Bank Branch
    f.  IFSC
    g. MICR

9. Attachment of the following documents with the refund application :
    a. Copy of FORM GSTR-3B for the period for which application has been filed
    b. Copy of FORM GSTR-2A for the period for which application has been filed

10. Verification

I_______ as an authorised representative of << Name of Canteen Store Department>> hereby solemnly affirm and declare that the information given herein above is true and correct to the best of my knowledge and belief and nothing has been concealed there from. I further declare that all the goods, in respect of which the refund is being claimed, have been received by us and that no refund has been claimed earlier against any of the invoices against which refund has been claimed in this application.

Date:
Signatory:
Place:

Signature of Authorised

Name:
Designation / Status

Instructions:

1. Application for refund shall be filed on quarterly basis.
2. Applicant should ensure that all the invoices declared by them have the GSTIN of the supplier and the GSTIN of the respective CSD clearly marked on them.