Government of India
Department of….
FORM-GST-RFD-04
[See Rule -]
Provisional Refund Order
Reference No : Date: <DD/MM/YYYY>
To
___________ (GSTIN)
___________ (Name)
____________ (Address)
Acknowledgement No. …………Dated ………<DD/MM/YYYY>……..
Sir/Madam,
With reference to your refund application as, following refund is sanctioned to you:
Refund Calculation | IGST | CGST | |
i. | Amount of Refund claimed | ||
ii. | Reduced by 20% | ||
iii. | Balance refund Sanctioned | ||
Bank Details | |||
i. | Bank Account no as per application | ||
ii. | Bank Account Type | ||
iii. | Name of the Account holder | ||
iv. | Name of the Bank | ||
v. | Address of the Bank /Branch | ||
vi. | IFSC | ||
vii. | MICR |
Date: Signature (DSC): Place: Name: Designation:
Office Address:
Download PDF Document In English. (Rs.5/-)
Comments