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FORM VAT- XII(COUNTERFOIL)

[See rule 30(1) of the Goa Value Added Tax Rules, 2005]

REFUND VOUCHER
 

Voucher No....................................

Refund Voucher for the refund of tax and/or penalty and/or interest Under the Goa Value Added Tax Act, 2005(Act 9 of 2005).
Refund payable to .......................................
TIN
           
issued by Commercial Taxes

Office................Ward.
Date of order directing refund.......................

Amount of refund: Rs..........

Number in collection register showing the collection of amount regarding which refund is made:-

(Signed)................

Designation..................

Dated:





(Office Seal)
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