FORM SBY-04
Acknowledgment
Applicant's Name :
SBY-UIN :
Acknowledgement Number :
Applicant's Name :
Your application for reimbursement is hereby acknowledged against <Application
Reference Number>
| Reimbursement Claim Details | |||
| Claim Period | |||
| Date of Timing of Filing | |||
| Amount Claimed | Central Tax | Integrated Tax (50% of the Integrated Tax paid) | Total |
Date:
Place:
(Signature of nodal officer)
Name of the nodal officer:
Designation of the nodal officer: