(Application for filing
a claim of rebate of service tax and cess paid on taxable services exported)
(PART A: To be filled by the
applicant)
Date………….
Place…………
To,
Assistant Commissioner of Central Excise/Deputy
Commissioner of Central Excise …………………………..(full postal address).
Madam/Sir,
I/We…………………………………..,(name of the person claiming
rebate) holding service tax registration No. …………………………………………, located
in………………………. (address of the registered premises) hereby declare that I/We have
exported ………………………………………service (name of the taxable service) under rule 5 of
the Export of Service Rules, 2005 to ……………………(name of the country to which
service has been exported), and on which service tax amounting to …………………….
(amount in rupees of service tax) and education cess amounting to …………………….
(amount in rupees of cess) has been paid.
2. I/We also declare that the payment
against such service exported has already been received in India in
full…………………………………………………. (details of receipt of payment).
3. I/We request that the rebate of the
taxable service exported by me/us in terms of rule 3 of the Export of Service
Rules, 2005 may be granted at the earliest. The following documents are enclosed
in support of this claim for rebate.
1.
2.
3.
(Signature and name of the service provider or his
authorised agent with date.)
(PART B: To be filled by the
sanctioning authority)
Date of receipt of the rebate claim:
______________
Date of sanction of the rebate claim:
______________
Amount of rebate claimed: Rs.
______________
Amount of rebate sanctioned: Rs.
______________
If the claim is not processed
within 15 days of the receipt of the claim, indicate briefly reasons for delay:
Place:
Date:
Signature of the Assistant Commissioner/ Deputy
Commissioner of Central Excise.
