FORM XXXIII TRIPURA VALUE ADDED TAX ACT, 2004 APPLICATION FOR REFUND ( Under Rule 35(2) of TVAT Rules, 2005 ) Charge No. : __________ Dated :_____/_____/_____ Dealer's TIN :______________________________ Dealer's Name : _____________________________ Address : _____________________________ _____________________________ Period of Assessment : ________ - _________ for which Refund Claimed Details of Payment : Date of Payment Treasury / Bank Challan / Scroll No. Amount Amount of Refund Claimed : __________________ Grounds on which Refund Claimed: _______________________ Signature ........................................... Status ................................................
