Department of Value Added Tax

Government of NCT of Delhi

Form DVAT 21
(See Rule 34 of the Delhi Value Added Tax Rules, 2005)

Delhi Value Added Tax Refund Claim Form

1. Registration No.

2. Full Name of Dealer

(For individuals, provide in order of
first name, middle name, surname)

3. Dealer’s address Building Name/ Number

Area/ Road

Locality/ Market
Pin Code

4. Tax refund claimed (attach supporting documents) Rs.

5. Ground for claiming refund

(provide reasons in detail, attach
additional sheets if required)

6. Verification
I/We __________________________________________ hereby solemnly affirm and declare that the information given
hereinabove is true and correct to the best of my/our knowledge and belief and nothing has been concealed therefrom.

Signature of Authorised Signatory _____________________________________________________________

Full Name (first name, middle, surname) _____________________________________________________________

Designation _____________________________________________________________

Place

Date
Day Month Year

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Instructions for filling Refund Form (DVAT-21)

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.

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 Department of Value Added Tax
Government of NCT of Delhi

Form DVAT 21A

(See Rule 34 of the Delhi Value Added Tax Rules, 2005)

<< Date >>

Reference No << Reference Number >>

To
_______________ (Name of the dealer)

_______________ (Address of the dealer)

_______________ (Registration Number of the dealer)

Notice for furnishing security for granting refund

This is in response to your application for refund submitted in form DVAT-21 on <<<Date of deposit of form>>, claiming a refund of
Rs. ______________ (in figues) _________________________ (in words) ; and

The said application has been examined and duly verified by the Delhi Value Added Tax Department. However, the refund of Rs.
_________________ can only be granted to you upon furnishing a security/ additional security of Rs. ________________ (in
figures) ____________________________ (in words).

You are hereby directed to furnish the security for the above-mentioned amount by <<<Date>>>> and provide proof thereof to the
undersigned so that the refund can be processed accordingly.

(Signature)

(Commissioner)

(Place)

(Date)

Department of Value Added Tax

Note: Please quote your Registration No. while communicating with the Delhi VAT Department in this matter or in any other matter
whatsoever.