FORM A-2
APPLICATION FOR CLAIMING REFUND OF SERVICE TAX PAID ON SPECIFIED SERVICES USED FOR AUTHORISED OPERATIONS IN SEZ
To
The Assistant/Deputy Commissioner of Central Excise/Service Tax
___________ Division, _______ Commissionerate
Sir,
I /We claim refund of Rs.................. (Rupees in words)
- (a) in respect of service tax paid on ‘wholly consumed’ specified services used for the authorized operations in SEZ, as approved by the Approval Committee of the _________ SEZ [ Rupees ____________]
- (b) in respect of service tax paid on specified services, other than those that are wholly consumed, used for the authorized operations of SEZ Unit/Developer, as approved by the Approval Committee of the _________ SEZ [ Rupees ____________].
1. Name of the SEZ Unit/Developer:
2. Address of the SEZ Unit/Developer with Telephone and Email:
3. Address of the Registered/Head Office with Telephone and Email:
4. Permanent Account Number(PAN) of the SEZ Unit/Developer:
5. Import and Export Code Number:
6. Jurisdictional Central Excise/Service Tax Division:
7. Service Tax Registration Number/Service Tax Code:
8. Information regarding Bank Account ( Bank, Address of Branch, Account Number) in which refund amount should be credited/to be deposited:
9. Details regarding Service Tax refund claimed:
9.1 Refund arising out of ‘wholly consumed’ specified services:
9.2. Refunds arising out of specified services, other than those are ‘wholly consumed’:
I/We request refund of service tax paid on specified services, other than those that are ‘wholly consumed’,-
(a) used in the manufacture of final products exported from SEZ
(b) used in providing output services exported from SEZ
I/We furnish following true and correct particulars, in Tables ‘B’ and ‘C’, for the purpose of
above refund:
Instructions for compilation of the above statistical table:
(i) To calculate the export turnover of SEZ, in the case of export of goods, FOB value provided in Shipping Bills or Bills of Export, should be taken into account, which have been duly certified by the officer of customs to the effect that the goods have been exported;
(ii) To calculate the export turnover of SEZ, in the case of export of services, value of output services exported shall be on the basis of certificates issued by the bank certifying the realization of export proceeds.
(iii) Amount of service tax claimed as refund, under Table B read with Table C: Rupees__________________
(iv) Particulars filled in the Table C should be verified and certified as true by the statutory auditor of the SEZ Unit/Developer
-------------------------------------------------------------------------------------------------------------
10. I/We Declare that-
(i) information given in this application for refund is true, correct and complete in every respect and that I am authorised to sign this application for refund of service tax;
(ii) the specified services, as approved by the Approval Committee of SEZ, on which exemption/refund is claimed are actually used for the authorised operations in a SEZ;
(iii) refund is being claimed only on the service tax actually paid on the specified services used for the authorised operations in a SEZ; refund of service tax has not been claimed or received earlier, on the basis of above documents/information;
(iv) We have not taken any CENVAT credit of service tax paid on the specified services under the CENVAT Credit Rules, 2004;
(v) accounts or documents furnished as proof of payment of service tax being claimed as refund, as per the invoice, bill or challan of the service provider indicating the service tax paid on such specified services, are true and correct in all respects;
(vi) proper account of receipt and use of the specified services on which exemption/refund is claimed, for the authorised operations in the SEZ, is maintained and the same shall be produced to the Officer sanctioning refund, on demand.
Signature and name
(of proprietor/managing partner/
person authorised by managing director of SEZ Unit/Developer)
with complete address, telephone and e-mail
Date:
Place: