FORM-GST-RFD-04

[See rule 91(2)]

Sanction Order No:                                                                       Date:<DD/MM/YYYY>

To

___________ (GSTIN)

___________ (Name)

____________ (Address)

Provisional Refund Order

Refund Application Reference No. (ARN) ……………Dated……..<DD/MM/YYYY>……-Acknowledgement No………Dated ……….<DD/MM/YYYY>………

Sir/Madam,

With reference to your above mentioned application for refund, the following amount is sanctioned to you on a provisional basis:

 

Date:                                                                                                                                                             Signature (DSC)

Place:                                                                                                                                                            Name:

Designation:

Office Address:

 

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