Form GST PMT-03A

Order for re-credit of the amount to cash or credit ledger on rejection of refund claim

[See rule 86(4B)]

Order for re-credit of the amount to electronic credit ledger

Reference No:                                                                                                                                                          Date:

    1. GSTIN –
    2. Name (Legal) –
    3. Trade name, if any
    4. Address –
    5. Ledger from which debit entry was made-                                                       Cash/credit ledger
    6. Debit entry no. and date –
    7. Payment Reference Number (DRC 03):_______ dated________
    8. Details of Payment: –
sl. no. Cause of Payment (Deposit of erroneous refund of unutilised ITC or Deposit of erroneous refund of IGST)
9 Details of Refund Sanction order 1. Shipping Bill/ Bill of Export No. and Date __________ 2. Amount of IGST paid on export of goods  __________ 3. Details of Exemption/Concessional Rate Notification used for procuring inputs  ____________ 4. Amount of refund sanctioned  __________ 5. Date of credit of refund in Bank Account  __________ (or) 1. Category of refund and relevant period of refund __________ 2. GST RFD- 01/01A ARN and Date  __________ 3. GST RFD-06 Order No. and Date  __________ 4. Amount of refund claimed  __________ 5. Amount of refund sanctioned  __________
10. No. and date of order giving rise to recredit, if any – 11. Amount of credit –
S.No. Act (Central Tax/ State tax/ UT Tax/ Integrated Tax/ CESS) Amount of credit (Rs.)
Tax Interest Penalty Fee Other Tot
1 2 3 4 5 6 7

Signature

Name

Designation of the officer

Note: “Central Tax‘ stands for Central Goods and Services Tax; “State Tax‘ stands for State Goods and Services Tax; “UT Tax‘ stands for Union territory Goods and Services Tax;  “Integrated Tax‘ stands for Integrated Goods and Services Tax and “Cess‘ stands for Goods and Services Tax (Compensation to States)”;