B C D E FORM

F 501 G H I J K
1 FORM 501 (Ver 1.3.0)
2 (See rule 60(1)) Validate FORM 501
3 Application for refund under section 51 of the Maharashtra Value Added Tax Act, 2002

4 To
5 Refund Processing Officer
9 Sub: - Application for refund under section 51 of the Maharashtra Value Added Tax Act,2002
I/we, the undersigned,has /have filed return in which Refund has been claimed by me / us. The details are as under:
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11 1 Category of the dealer claming refund (Please Select one or more appropriate box/es)

Exporter (EXPORT SALE Unit specified In PSI unit holding Dealer claiming Newly registered dealer
SHOULD BE >50% OF TOTAL the Explaination To Entitlement Refund in last Return Claiming refund at the End
SALE) sub-section(3) Of Certificate of the Financial year of second financial Year
12 section 8

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14 2 Name of the dealer

15 3 MVAT – TIN

16 a) W.E.F Date R.C.C Date

17 4 CST TIN

18 5 Entitlement Certificate No.,if any

6 Certificate No. issued by JCST in respect Of

19 dealers covered under sub-section (3) Of section
8, if any
20 7 Address of place of business
21 a) Room/Floor No.
22 b) Building Name/No.
23 c) PlotNo,Street and Area
24 d) City
25 e) PIN Code

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 B C D E FORM
F 501 G H I J K
28 f) District
29 8 Details of Bank Account in which refund Sought
30 a) Name of Bank
31 b) Name of Branch
32 c) Account Number
33 9 Period of the return in respect of which Refund is claimed From To
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35 10 Nature of return filed
36 11 Return Form Type
37 12 Date of filing of return
38 13 Amount of refund claimed as per this Application (Rs.)
39 14 Amount of refund claimed so far during the year From To
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41 Amount (Rs.)
15 Tax paid/Refund claimed From To Tax Paid (VAT+CST) Refund (Rs.)
42 during the previous Year (Rs.)

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44 16 Whether willing to furnish Bank guarantee (Please select)
45 17 Name and designation with whom contact is to be made with phone and mobile no.
46 a) Name of the Person
47 b) Designation
c) Mobile Number Telephone No. with
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STD code
18 I/we, hereby declare that I/we is /are a dealer holding certificate of Entitlement Under Package Scheme of Intensive and
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the amount of refund claimed is under Rule 79. (Applicable only for PSI units)
19 The particulars given above and in the statement of purchases annexed hertero are are true to the best of my knowledge
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and belief.
20 I / we are ready to comply with the necessary requirements.You are requested to grant the refund in my/our case.
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21 Place (MSTD Name of the

52 Location) partner/Proprietor/Director/
Authorised persion

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 B C D E FORM
F 501 G H I J K
53 22 E-mail id Designation
54 23 Fax no
24 Tel. No. with Mobile No
55
STD code
25 Date of Refund Remarks
56 application

57 Instructions For Submission Of Forms

58 1.All The Fields In red Colour are Mandatory

59 2.After Filling The Fields Please Press The Validate Button
60 3.Please Correct The Mistakes Pointed Out By Validate Function
61 4. Please Check the ERRORS Excel Sheet for Any Errors.
62 5.Remarks if any Enter in Box No 25
6. If " Press To Validate " Button is not operative , please ensure that MICRO SECURITY in TOOLs menu of Excel Sheet has set at
63 MEDIUM or LOW

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 B C D E Annexure A F G H
1 ANNEXURE-A
Validate Annexure A
2 TRANSACTION WISE VAT PURCHASES
1.Period Covered by the From To
4
Annexure(DD/MM/YY)

5 Note : if the refund is brought forward from the earlier return period , then this annexure period should be from the first date of
such return period till end of the return period in which refund is claimed
6 2. Other Local Taxble Purchases Amount Rs
7 3. Total Taxable Purchases in the State Total Of 2+4 0
4.List of Transaction wise purchases / Credit Notes issued by suppliers / Debit Notes issued by claimant dealer in which VAT is
8 shown separately (The figures of Debit Notes / credit Notes should be entered as negetive value)

Sr.No Tax Invoice / Tax Invoice / TIN of Supplier Net Taxable Input VAT Amount Gross Total
Credit Note / Credit Note / Amount (Including other
Debit Note No. Debit Note Date non taxable
(DD/MM/YY) charges
9 collected in bill
such as
insurance)

10 1 2 3 4 5 6 7
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 B C D E Annexure A F G H
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 Annexure B

B C D E F G H
ANNEXURE-B
1
Validate Annexure B

2
To,
3 1 Refund Processing Officer
4 2 NAME OF THE CLAIMANT DEALER 0
5 3 TIN NO 0

Applicable Refund
6 Scheme.
Sub: No Dues Certificate for claiming refund under
7 4 For return period From To
8 0 0
9 5 For Refund amount Rs. 0
6 Refund Amount In Words
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11 This is to certify that, therer are no outstanding Dues against me / us either under the MVAT Act, 2002 or the CST
7 Act, 1956.
8 The above said Refund is not carried forwarded or as the case may be adjusted by me / us to any subsequent /
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previous periods.
9 If, it is found as a result of any order passed under MVAT Act, that the refund granted is in excess of the refund, if
any, determined as per the said order, then excess amount be recovered as if it is an amount of tax due from me
13 / us and I / We shall be liable to pay simple interest at the prescribed rate per month or part thereof from the
date of grant of refund.

10 Date 0 Name of the 0

partner/Proprietor/Di
14 rector/ Authorised
persion

15 11 Place 0 Designation 0
16
17

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 B C D E F G H I J K L
1 ANNEXURE-C
2 Declarations or Certificates not received Under Central Sales Tax Act, 1956 Validate Annxure C
1. Period Covered by the Annexure(DD/MM/YY) From To
3

4 Note : if the refund is brought forward from the earlier return period , then this annexure period should be from the first date of such return period till end of the return period in which refund is
claimed
5 2.Transaction wise List
Sr. No Name of the Dealer who has not CST TIN if any Declaration Invoice No. Invoice Date Taxable amount Tax Amount Rate of tax Amount of Tax Differential tax
issued Declarations or or Certificate (DD/MM/YY) (Rs.) (Net) (Rs.) applicable (Colmn 7*9 *%) liability (Rs.)
Certificates type (Please (Local (Col. 10-Col. 8)
6 specify) Rate)

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 B C D E F G H I J K L
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 B C D E Annexure
F D G H I J
1 ANNEXURE-D
Validate Annexure D
2 Declarations or Certificates received Under Central Sales Tax Act, 1956.
1.Period Covered by the From To
4 Annexure(DD/MM/YY)

5 Note : if the refund is brought forward from the earlier return period , then this annexure period should be from the first date of
such return period till end of the return period in which refund is claimed
6 2.Transaction wise List
Sr Name of the dealer who CST TIN Declaration or Declaration Invoice No. Invoice Taxable (Net) Tax Amount (Rs.)
No. has issued Declaration or certificate or Date Amount (Rs.)
certificate Type (Specify certificate
7 form or No.
certificate
type)
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