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Government of The People's Republic of Bangladesh National Board of Revenue
Government of The People's Republic of Bangladesh National Board of Revenue
Government of The People's Republic of Bangladesh National Board of Revenue
3. Address of Taxpayer 72, JAYMOT KHAN ROAD, PAGAR, TONGI; Tongi PS; Gazipur - 1710; Bangladesh
Value SD VAT
Nature of Supply Note
(a) (b) (c)
68
Requested Amount for Refund (SD)
I hereby declare that all information provided in this Return Form are complete, true & accurate. In case
✔
of any untrue/incomplete statement, I may be subjected to penal action under The Value Added Tax and
Supplementary Duty Act, 2012 or any other applicable Act prevailing at present.
Signature
[Not required for electronic submission]
Sub-form of Part - 3.4: Standard Rated Goods/Service
Goods / Service
Goods / Service Value* SD* VAT*
Commercial Goods / Service Name Notes
Code* (a) (b) (c)
Description*
Art.Of App.&Clothing
Plastic Molding 3926.20.90 Accessories(Exl.Gloves)Of 4,84,740.00 0 72,711.00
Plastics Hd.No.39.01-39.04
Sub-form of Part - 4.20: Goods/Service Not Admissible for Credit (Local Purchase) - From Unregistered Entities
Goods / Service
Goods / Service Value* SD* VAT*
Commercial Goods / Service Name Notes
Code* (a) (b) (c)
Description*
112 Sonali Bank Ltd. Tongi Bazar 10/10/2022 1 / 1133 / 0015 / 0311 44,320.00
TOTAL 66,247.00
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