Department of Goods Tax Government of Arunachal Pradesh Form FF-09 (See Rule 47 of the Arunachal Pradesh Goods Tax Rules, 2005) Arunachal Pradesh Goods Tax Refund Form 1. Name of Dealer ________________________________________________ 2. Registration Number 3. Address of Dealer Building Name/ Number _________________________________________________ Area/ Road _________________________________________________ Locality/ Market _________________________________________________ Pin Code _________________________________________________ Email Id _________________________________________________ Telephone Number(s) _________________________________________________ Fax Number(s) _________________________________________________ 4. Total Tax Refund Claimed (with supporting documents) ________________________________________________ 5. Grounds for claiming refund (in detail) ________________________________________________ 6. Details of security ________________________________________________ 7. Manner of computation of security ________________________________________________ 8. Verification I/We _______________ hereby solemnly affirm and declare that the information given in this form and its attachments (if any) is true and correct to the best of my/our knowledge and belief and nothing has been concealed therefrom. Signature ________________________________________________ Name ________________________________________________ Designation ________________________________________________ Place ___ ___ / ___ ___ / ___ ___ ___ ___ Date DD / MM / YYYY Instructions for filling Refund Form (FF-09) 1. Please fill only those claims for refund of tax, penalty or interest due under the Act which have not already been claimed in the return. 2. Please attach a certified copy of judgment or order in case the refund arises out of a judgment of a Court or an order of any authority under the Act.
