NOTE: This Form shall be deemed to have been omitted with effect from the 1st day of July, 2019 vide Notification No. 14/2022-CT dated 05.07.2022.

***OMITTED ***


[See rule 95A]

Application for refund by Duty free Shops/Duty Paid Shops (Retail Outlets)

1.  GSTIN:

2.  Name:

3.  Address:

4.  Tax Period (Monthly/Quarterly) : From <DD/MM/YY> To <DD/MM/YY>

5.  Amount of Refund Claim: <INR><In Words>

6.  Details of inward supplies of goods received and corresponding Outward supplies:

7. Refund applied for:

8. Details of Bank Account:

i. Bank Account Number

ii. Bank Account Type

iii. Name of the Bank

iv.  Name of the Account Holder/Operator

v. Address of Bank Branch

vi. IFSC

vii. MICR

9. Declaration:

I ______ as an authorized representative of ___________ (Name of Duty Free Shop/Duty Paid Shop–retail outlet) hereby solemnly affirm and declare that,-

(i) refund has not been claimed against any of the invoices in respect of outward supplies submitted with this application

(ii) the information given herein above is true and correct to the best of my knowledge and belief.

Date:                                                                                                                     Signature of Authorized Signatory:

Place:                                                                                                                    Name:

                                                                 Designation / Status


  1.  Application for refund shall be filed on monthly/quarterly basis depending upon the frequency of furnishing of return by retail outlets.
  2.  Application shall be made in respect of one inward supply invoice only once. Therefore, it is advised that refund shall be applied only for those inward supply invoices the goods received against which have been completely supplied.
  3.  Applicant should ensure that all the invoices declared by him have the GSTIN of the supplier and the GSTIN of the respective Duty Free Shop /Duty Paid Shop (retail outlet) clearly marked on them.
  4.  Documents to be attached with the refund application:

a)  Undertaking that all indigenous goods on which refund is being claimed have been received by the Duty-Free Shop/Duty Paid Shop (retail outlet);

b)  Undertaking that the indigenous goods have been sold to eligible outgoing international tourist;

c) Copy of the returns for the period for which application is being filed.]]

1.  Inserted vide Notification No. 31/2019-CT dated 28.06.2017 w. e. f. 01.07.2019.

2. Omitted vide Notification No. 14/2022-CT dated 05.07.2022 w. e. f. 01.07.2019.