CHECK MEMO
FOR REFUNDS UNDER THE A.P. VAT ACT’ 2005
1 Name and Address of the VAT dealer :
2 Tin :
3 Nature of Business with details of :
Commodities and Inputs with Brief History
On dealer’s activity.
4 Tax Period of VAT 200 :
(a) Date of Refund claim by the dealer :
5 Excess Credit Carry forward claimed in the :
VAT 200 return
6 Whether the dealer filed all the returns
(I) APVAT :
(II) CST – VI :
7 Whether the dealer has filed VAT 200A & :
200 B by restricting ITC on Exempt
Transactions exempt sales if any.
8 Whether the STR claim is correct as per :
VAT 116 / 126
(a) Dealers having exempt transaction/
Exempt sales by filing VAT 200G/H :
(b) Others Dealers :
9 Amount of Input Tax involved (ITC) in :
Boxes 7, 8, & 9 of the VAT 200 during
The tax period
10 Nature of Audit Conducted
(a) Auditing Date :
(b) Specific points noted in restriction of :
refund and Brief report of Audit(Separate
Sheets may be enclosed, If necessary)
(c) Whether proceedings in Form 305A :
passed, if not give details.
(d) Penalty levied if any :
11 Whether purchase details in Form 225 :
Furnished and cross check references
Issued and result of cross check.
12 Whether the dealer has adjusted any entry :
Tax in Box 22(a) on eligible goods and
Filed VAT 503
13 CST Adjustment in Box 24(a) if any :
14 Whether the dealer is in arrear of Taxes/ :
Penalties/Interest under APVAT Act-05
or APGST Act, 1957, or CST Act 1956 or
A.P. Entry Tax Act
15 Date notified in the refund advise of :
Form VAT 355
16 Date of Approval of DC (CT) in Form Vat :
355 A
17 Signed in Refund Voucher Form 500
Voucher No. Date
18 (I) REFUND DUE TO EXPORTS
1(a) Zero Rated Export sale Turnover
Reported in Box.13 or VAT 200 During
The Tax period.
I(b) U/S. 5(1)
If exports fall under U/S. 5(1) furnish
Details of the documents as required under
Rule 35 (6) (a) of A.P. VAT Rules in
Annexure-1.
Evidence of export in the Form of
(a) Copy of Customs Clearance Certificate :
(b) Copy of Contract of Order Form Foreign :
Buyer
(c) Evidence of actual export copy of bill of :
landing or copy of airway bill or any other
relevant documents
(d) A Copy of letter of credit or evidence of :
payment
I(C) U/S 5(3)
If the exports fall under the sales in the :
Course of export U/Section 5(3), furnish the
Details required under Rule 35(6) (b) of the
APVAT Rules,05 in Annexure-II and
Restriction of Refund on account of
non-filing Of “H” Forms, if any
Evidence required for Zero rate sales in the
Course of export
(a) Form “H” declaration Form :
(b) Purchase order form the exported :
(c) Evidence of Export in the Form of :
Transport documentation
18 (II) REFUNDS DUE TO GOVT. ORDER
(a) Is the refund due to Govt. Specific order :
Furnish the details and period of operation
and modified orders if any (Mention details
of G.Os)
(b) Specific details and remarks :
18 (III) REFUNDS DUE TO EXCESS INPUT
TAX CREDIT
(1) Amount Shown in Box No. 23 of VAT 200 :
Form
(2) Amount disallowed Reasons for :
Disallowance
(3) Amount authorized for refund :
(4) Whether Credit Carried Forward is :
Aanalysed and verified for all the tax periods
18 (IV) REFUNDS DUE TO APPEAL
ORDERS OR COURT ORDERS
Please furnish the connected orders with
the brief history of the case in the Form of
Note-file.
18 (V) REFUNDS DUE TO ANY OTHER :
REASONS SPECIFY
19 Remarks & Recommendation of Approval of :
The refund claim
(a) Name and designation of Officer-CTO/AC
Signature:
Name
Date
20 Remarks and recommendations of the
Dy. Commissioner
Signature:
Name
Date
Note:
1. Use separate Sheets wherever necessary.
2. Enclose copy of Audit with specific remarks on amount of refund claimed, disallowed.
3. Enclose all important documents/connected information to the refunds.
4. Proposals for refund claims are to be sent only after detailed verification of
Refund claim.
5. All the columns should be filled up neatly, wherever the columns are not applicable please write not applicable.
The CTO/AC and D.C are requested to pursue the file carefully before admitting the refund claims as they will be held solely responsible for the correctness and genuineness of claim.