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FORM VAT- XXIX

(See rule 5(1) of the Goa Value Added Tax Rules, 2005)


To,
The Commissioner of Commercial Taxes,
Government of Goa,
Panaji Goa. 

Sir,

I ................................. (name and designation of the officer signing the application) of the ......................, do hereby apply for reimbursement of tax collected on the purchases of goods made by me/us specified in the invoice /cash memo no...........dated...........of Shri/M/s ..................................................... who is/are registered dealer under the Goa Value Added Tax Act, 2005 (Act 9 of 2005)My/our Bank Account in India is under No................and the payment towards such reimbursement of tax be made payable by demand draft to be credited to the said Bank Account.Invoice/Cash Memo relating to the said purchases is enclosed in original.
Place:

Date:


____________________________
Signature of authorised officer

Status & Office seal_______________

Name Address of the Purchasing Official

____________________________________________________________________________________

____________________________________________________________________________________

Enclosed: invoice/cash memo (in original)
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