MATER TRA AAT oTShe aera Cae cal [SB ASTRO FHS AMEE AS | rT SHAAN 29 KAA, 982¥ TENA / 9 OPI, gods WT FAAS, AL OY4- HRY QODD/DO-IPAS |- FAY ALAM FA G AAS A¥H GMBH, Roy (ROS AGH 84 A GBA) A AA Doe 6 IHS HASTAC GTS ATE CIE FAY ACMA FA G HATH YE ARI, 2oDy aa Maga afdawa Aces ARM, Tat: ofa. Fafa WaT PTH D we AAAS Farge aT TED S eal ware, Vel GOVERNMENT OF THE PEOPLE'S REPUBLIC OF BANGLADESH | Mushak-9.1 ®@ NATIONAL BOARD OF REVENUE VALUE ADDED TAX RETURN FORM [Sce rule 47(1)] [Please read the instructions before filling up this form) Part-I: TAXPAYER'S INFORMATION BIN 2._| Name of Taxpayer 3. | Address of Taxpayer visit: fb.com/groups/vat.a2z | Type of Ownership Economic Activity Part-2: RETURN SUBMISSION DATA 1. | Tax Period 2 | Type of Rew + | A) Main/Original Return (Section 64) 1 [Please select your desired option] B) Late Return (Section 65) ) Amended Return (Section 66) C1 D) Full or Additional or Alternative Return (Seation 67) 3 | Any activities inthis Tax Period? Yes o No a [If Selected “No” Please Fill Only the relevant Par] | Date of Submission‘Nature of Supply Note] Value sD ‘VAT (a) 4b) (©) Zero Rated Direct Goods/Service Export Deemed 2 Export Exempted GoodvService 3 ‘Standard Rated Goods/Service 4 ‘Goods Based on MRP. 5 Goods/Service Based on Specific VAT | 6 ‘Goods/Serviee Other than Standard i Rate Retail/Wholesale/Trade Based Suppl 8 Total Sales Value & Total Payable 9 ‘Taxes 1) Ifall the produets/services you supply are standard rated, fill up note 10-20, 2) All the producty/services you supply are not standard rated or input tax credit not taken within stipulated time period under section 46, fill up note 21-22. 3) If the products/services you supply consist of both standard rated and non-standard rated, then fill up note 10-20 for the raw materials that were used to produce/supply standard rated goods/services and fill up note 21-22 for the raw materials that were used to produce/supply non-standard rated goods/services and show the value proportionately in note 10-22 as applicable. Nature of Purchase Note | Value VAT @ b) Zero Rated GoodvService | Local Purchase | 10 Import 1 Exempted GoodServiee | Local Purchase | 12, Import 13 ‘Standard Rated Local Purchase | 14 GoodsService Import 15 GoodyService Other than | Local Purchase | 16 ‘Standard Rate Tmport 17 GoodsService Based on | Local Purchase 18 Specific VAT ‘Goods/Service Not From Tumover Tax | 19 Admissible for Credit (Local | Units Purchase) From Unregistered | 20 Entities GoodsServiee Nov Local Purchase | 21 Aalmissible for Credit Import 2 ‘Caxpayers who sell only ExemptediSpecitie VAT and Goods/Service Other than Standard Rate/ Credits. not taken within stipulated time) ‘Total Input Tax Credit 23Adjustment Details Note VAT Amount Due to VAT Deducted at Source by the-supply receiver 24 ‘Sub-form Payment Not Made Through Banking Channel 25 Issuance of Debit Note 26 ‘Any Other Adjustments (please specify below) 27 ‘Total Increasing Adjustment 28 ‘Adjustment Details Note VAT Amount Due to VAT Deducted at Source from the supplies delivered | 29 ‘Advance Tax Paid at Import Stage 30 Issuance of Credit Note 31 ‘Any Other Adjustments (please specify below) 32 ‘Total Decreasing Adjustment 33 tems Note Amount. Net Payable VAT for the Tax Period (Seetion- 45) 34 (9C-23B428-33) ‘Net Payable VAT for the Tax Period after Adjustment with | 35 Closing Balance and balance of form 18.6 [34-(52+56)] Not Payable Supplementary Duty for the Tax Period (Before | 36 adjustment with Closing Balance) (98+38-(39+40)] ‘Net Payable Supplementary Duty for the Tax Period after 7 Adjusted with Closing Balance and balance of form 18.6 [36-(53457)] Supplementary Duty Against Issuance of Debit Note 38 ‘Supplementary Duty Against Issuance of Credit Note 39 Supplementary Duty Paid on Inputs Against Exports 40 Interest on Overdue VAT (Based on note 35) al Interest on Overdue SD (Based on note 37) a2 Fine/Penalty for Non-submission of Return 43 ‘Other Fine/Penalty/Interest ery Payable Excise Dut 45 Payable Development Surcharge 46 Payable ICT Development Surcharge aT Payable Health Care Surcharge 48 Payable Environmental Protection Sureharge 49 Net payable VAT for treasury deposit (35+1+43+44) 50 'Net_payable SD for treasury deposit (37+42) SI ‘Closing Balance of Last Tax Period (VAT) 52 ‘Closing Balance of Last Tax Period (SD) 33 Ttems Note Amount Remaining Balance (VAT) from Mushak-18.6, [ Rule 118(5)]_| 54 Remaining Balance (SD) from Mushak-18.6, [Rule 118(5)} | 55 Decreasing Adjustment for Note 54 (up to 10% of Note 34) | 56 Decreasing Adjustment for Note 55 (up to 10% of Note 36) | 57‘tems Note | Account Code ‘Amount VAT Deposit for the Current Tax 38 Period ‘SD Deposit for the Current Tax Period | 59 Excise Dut 60 Development Surcharge ol ICT Development Surcharge o] Health Care Surcharge a Environmental Protection Surcharge 4 ‘Ttems Note “Amount Closing Balance (VAT) [58 - (50 + 67) + The refund amount 65 not approved] Closing Balance (SD) [59 - (51 + 68) + The refund amount 66 not approved] Tam interested to get refund of my Closing Balance ‘tems Note | Yes (No Requested Amount for | 67 Refund (VAT) ‘Requested Amount for | 68 Refund (SD) Thereby 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. Name Designation Mobile Number National [D/Passport Number Email ‘Signature [Not required for electronic submission]‘Sub-form : (For Note - 1, 2,3,4,5.7,10,11,12,13,14,15,16,17,19,20,21and 22) seria | emms/ Servite | Goods Goods) | Value | SD | VAT | Nog et | Smtee | Service Code | Service Name | @) |) | TOTAL Sub-form: (For Note - 6 and 18) ‘Actual Sees! | Goods | Goods’ | Unit ot Sales! | gy | var Serial Service | Measure | Quantity | Purchases Notes rial | Commercial eS @ | © 0. ame | (a) | Value Description © TOTAL Sub-form (For Note - 8) Goods/ : : 7 | Gooas/ | Goods / Seri | Caterory | | Servet | Sotice | Sere | Valve | SP | VAT | Nats : Commercial | “Code | Name escription T | Commerciat Importer/ Other traders 2_| Petroleum product 3_ | Super-shop Medicine related 4 | product ‘TOTALSub-form (For Note - 24) Tax vat : tn var] tac | depen Seri | sappie’s | suppers | sursiers | aie | peiucea | Nezeailan | msi | Detucton | poveton | depos | ‘seal | BIN | Sime | Adare sts | pane.” | Clan’ | atrouree, | Sicerce, | Accum | number a) titente | Coremcte | “Cole. | af Book cate anor TOTAL ‘Sub-form: (For Note - 29) Tax var] vat A Invoice NoJ | imac! | Detection | Detocion | 8%, | 828 | tax No | Buyer's | Buyer's | Buyer's | vaiye | neducted | ‘Challan’ | Chatlan/ | atsource, | atsource, | eves | serial | genoa | Notes VAT" | warRovet) | BilDate | Cericate | Cert ‘hte ete | Cerete | A | honk Santer TOTAL‘Sub-Form : (For Note - 30) Custom Serial | Bill of Entry Advance Tax Ne Necker Date House/Customs ener Notes Station ‘TOTAL ‘Sub-form ( For Note - $8,59,60,61,62,63 and 64) Serial | ‘Treasury Challan ‘Tax Deposit aa naa Bank Branch Date | ee eeee | Amount | Notes TOTALspre miRea facts Petre @) @) (9) (8) (@) ie aia ACTA TERN TEATS MOAT £2 BT FET ARCRTO TaL OHMS YF A, ody oat StowTA Rafe et fa oa ae Real Rafe Rerebo cca acoveryTM Bet safRercary Bea af SACTMTCHA oACIPS SAT SACTATH AAAS AIO Se SHRCLA ACHT comm SRCT Rei Gres PCB a Pe wa whe aeCIA CIN MIRE Cte Ie fea Fate ee Reece wife comt fhe tact aT al ede t GoRe x0 cA CM at sofa rca He atfoe at wedi GORE TACIT BEC CA aera er 1H eT oa fed AN err eH ATS Ree et ea IATA arares aifecere =I wifRerta cote ocd at ARTA YIS-v.S0 Ga OAS CH FIA! Fete scr weer mea co at RH SI ete Bia eReaR Fe Fee IAT TT CE Se BT TERT ARCA @) @) (9) (8) @ © AT PRD Ge ROT aaataes miRies cmt Fee 6 weeTaaTs ae! SRT MIRE CA TAT wwwvatgouibd SBE SPR! Stata STA YM aT aI STS See rife! OFbIA Rese MIME STA CM sfACS MICA! ATA Fede) ‘Sib aa aS CHbICAA Beta wwwinb.gov.bd WCE COTA Rl eigen wae cae Cara Fat 6 rae ar a mR cea PA Ca Bats oa aia afm aia nee TER 28 era ARG ope GR RECA BA ARICA RCE CAPITAL SHA TRTA =m aie at steel eles ora ob CA a aye mera Se Ae Garba Bag afer aprat face BRC atawed orf cae SI wa ofaats wuefeHETCE Att wat Gere erareftene aaaate Feea AA aR oT araftte e8ca at IN coco BH, ee TRC WaIHAT oa SCS Beal areola canragia ayers aR tetas efinecata FeaICa al PACS BAI “ore eicaa A/F SRNR CMR CTE CAR HO A TTA WTA eT GAA (96%) A/C AFAR SAR FAT VANCE AZ fra aare a Bho aeT 6 ca PARC , aOR RECA we a RCS aned ea ete aren fefee H/F SAR COMMS CRT HE A Fa PTA TAT STL Fa ae Tere fox Ta FSS AH/CM HATE SIT al RANE OR ofa APU ea TE FAH Ge aH Face ete FH SAH GHIA way ACTA ACAI ATR) wired Bay aR GATS AR NBR BAM aera apa efice teal areeCkA corer TE waftererca ae fivenra RReirca eae eBra1 aie clea aE, Seem aeeTtA waft ofa SAAT Real aot cerry eta TT Rr efieeata Roma ae afie zea Para wih Bee SARA CAA CRC] GIR Hee FA Dlg ETAT payne yer (Slew olshyeret AaaaTE ora FAT Ree CAE fra ae wa IETS eT ek wea FACS RAL AM BATH GER WAS PATA ON ATR TARO way aT BT 9 Ae CATA egg aa ATE Mt -affce eee areola ces ayaa ye PRICE fing as Fes ane eee RIE COM ATH, eteiee ATTRA Gane pa SATS Rea) vectra gate TA IRAE efiveia Fate fae FRCS REELacta eTS SESTHSTHOFHT OTHE HEHE Latest + ON+ GIF IED SRR Ca Chea FicbH HCAS RH AT, ID HOCH FT ARCH Ba OE AE wa AAT FR fica ORAS: OF - BAeat ea (o) eae arate He eA eH ICE EH, CFR CAC 30-30 AH EAL (9 saat Tepe re af we etc a Ore MTT 88 aS ITCH HT RTE ee HCE ARH TAT SH TLC OWLH GID SN FH (09 saa cares an MPH rd er ee Me TES GSH RY, OTOHTS AHH BOTA BoeRCA AUR SMM SH FH SGPT Ue ATTETOT SATA GAG $088 FM FAL do DARTS Pe Grate cred CRE OT AR EAN Boreal ST seo. | gprars RME or afera HPT we TES HAT Ae TH aa eT faRicw ara) a8 ad are “esi ae aN ara eCbICTA TT ATE I TAG CAT aT AC ACA ATL ACA "Sub-form" bre fre Sfacs Rae Go are eee Ree AIRWOE CeNCT see RCE Rea SUPE A/OHRT wl eae APSE EATS AAS BIB WHA A/T AA SHOT ates etatare seryorata ata raefiemstca siteore ot aera Si wT ee eT ETA T/T arm wey ere eatR wa MTOR AT CATE corey TE safeeica meine Reis tah aca) ater ami Se OS aa ofsa wuefeAEIa tat Fat LeCIS apres PARRY on Foote aa eIRetca St ats Zee a 2 Sige otc ay, acim aaa wap oper @FRCSeT sents fata twos a SAAR Co CHCA GR aeR wTMaGe Bre apres RAB, OR ofa ayAT Fa TES ET Ay UA FaRC RAI = 0948 © oral ores crea Picky wires oT ‘frataet fecal a GR fe igre aries orca aay AIceR WaT TAMTO Ge wacratera | pacar HATA CoH CHT ARATE FA) BH AE RTA Cora PARC BALA! HATS HICH TB wee BCS CATD wa Face cess | faa artes eect) ie!) 2 creer MARC CTE, aH AINA CTR OTacta eTS SAARI ARTA CH. CHET ALCTINA a) BH CaS ete Ae, oaetice Facba merece fe ‘ofa! cr Cte ra aie aR CRA eA ARE OAT TAME OT SACARTENA AAA CoA TAS IH) BE GTS TARTS SIT CR | RRea) ARAB AIC GIG BY AO AIG wy Aa wea Ome! | wiz Beal smite wR oR, ser TOT ORE ote RCTS TAR CO TMT MR BH TS TCT 22, oaBIcs Pca neRSTC ers AFIT Ber: aon Dah POT TT a8 WPS Sew oH Oo © SHMTEHE STD IH, SBS ar GAIT Dae Roe CHE Se) PUM sprees Pew aT core ARTA PAF Se CPR) IRR | ene ateter pera Aa cra ae aiftate CeeTET se@] | Bax eer Cs eo ee orc set cot | yyy Seu apse een Ps RTA cos ee IP Cre Deb STS CACHE PMR SRA ATA CoA Ce FAT Hie eRe Bea FCA 4] ae | mre |e saniei caid 08 a CBR afaarera ALAN 0% ARH TATE) | fica alel GAIb 00 a ISIC HALAS BRA ra EPPA |e FATT GIP ow 2 CAAT ATCA ACA 30% FAL ae SARCAR TEI ATG 09 a RRREPTASTCA AAAS LEA CPE TH) Bea: Fa ACM SHAT SAT) Gy [RETR Pe RRR CITA CCE A BATH GHA SAT ATO RTA FRCRHIT APR! BACT "Sub-form" Ia few SCE BAe eae eT ofrcontirs wraed ome eara) aeelA wae oa FACT Gare apr | eae tae spre oifcaten DET ARR ae CFR BIR Er ea BO FET eTISE cise OTE BICEA fare east face ZBca1 Ie ase ake BRT ey Ae AS aes SEI IROKE aACATRRE pices cates ayaa TRE eho Rott exits eaca1 2 BIg crea ay, ae aTAeTa CaN ose BFCook sents fata tts ea © Bec CeICER CCE aM cH aaTCAMBA OTE (9) #P35%, ante 6 SB Fier, ye 0009 (3) FPO, GaTRG 6 STG SMTTAE, TIA: 000g (9) FR FATT WAE-PTE: 0008 (8) FrSaF, GHTET © STS sfaTeAD, oTeT (HPPA): cose (@) SPOHA, GHWT G SHS SHrrateas, ors (GSA): code (y) BP Ba, cate 6 SIG AIcAD, FACAB: ody (4) Fr bay, aster ¢ ENG sirarcab, aterst’: coro (o) FP BRA, SHV G Sb SAPAICAD, DOTA: core (a) SPB, GREG HT eBerICAB, BIE (4): 0080 (90) rE, eae 6 STE FtteAd, viet (AER): coee (09) FSH, amtea @ eT wfemTeAs, Gfitm: 0080 (99) SSF, GoTRT @ STD FMEA, AeA o08e (99) BRASS ATE OPTS) 9/9009 / SHA ATS foods (98) FACARSF GIS CYTE TH) Yee /SRPA CATS Jo%9 (9¢) Bafienfte spreA WAT IA ysyoo/afien cE Joos Oe) SARone TPE ATE or oT I ydoe/afeH catjo99$ 09) 84 78 @ wfRaIAT Sssoe/eTH CHIE /SBOD (ob) STaMTfa MPs YaDoo/STEA CATS food (a) SHIA AAT SPd99/0000/222¢ (30) Soy Safer CHAT ATABTE s/9999/0000/3838 (G9) BPH ARH ABTA Y/999e/0000/99d% (32) ARC BHT ATABTE /9999/0000/2390 @ 7am IG ame © GON CMM CHS BET ACH CTA A RC CRT AIR AIRECL way ATER GI GIS eb AC eH CHIE cafteu eapiae #fRce Rea 9 Fe crea aa, stem areCA WaT oa AACEeT eal ae coe ETE a ace ae Pingats tea oat oFR0S 22 wo aiaeifa © SHMECT CAME CRE FR FATA CHT AY OTR ALTA, BR ARETE Oa SATE OT GIP ob em TEM AAT aap fae 2c) 9 aig ters ary, ae ara wap eps FRCS cal aera come gata aN Roca refines Pc ofa ARCs eC Gana sabe © SOR CHCA CE Hel ACH COTE GA IRC ATM ARI AIRED ey ATER GT GAD ob gM ef caeprae wfc zecal 9 SITs orca aay, See aTaeTa wane ose FRCS Ra) aera unr gare A ietCE Piva Rite oa fe 281 we Gana stabi © BRET CALA Crea YT BACH CHIH OH aA BOTA AI) UC way SMTEAR GT GHB ay AR OF RAH afer wep whice ea ier crea a, em eC was Aa AACS Real areca coneragia ya ye aR efits Roatea ose wfRCw 2B ae ET © SAR CAR CCE FA BA HRY SAY ATTA ALATA AR) aawet wey aATEIE GT GIT eb AR wa SAAT ofiea eaprat face Bea) 9 SI ones a, 2 ATCA weNTAT oH RCE Real aera corey Rte BT ace ne Pinan (Race oat 80 2241 RC ATT © SMT CAAA COLE YA FATA CHT SAY aA ALETA AIR) ITEC aT SATE AT GIS ab AL a GT affem agree face eee 9 ITe cotena oraR, sete ATCA wap eps whATS ei oeecla cone pata yt aft se Pre PN ae WARTS BATA SeA-S0: HATA COT aI Cort CES ARCTER © ot Sarre ae) FACT ET ACCOR Fee erate cota flora myc cera aan Rea‘Fecuiste cra PA: we = [er - (Go + UA) + FaHTSL Se wifes freresa ofa ater wf ReaTA/ FHT Module FSF aaaas waa + SAR Ciera crea BO MTOR FeHTOTA eB) ACTIONS BP HCHO Hes eae CONTA fara Bites face ral ra CPR Ts) 2 eB waters taadl exCaMTOTE THRE CER arate cara Feira ire cera ara Facet FRC © Faces FAH: we = [2d - (09 + Ue) + FART eee IRS firmesa afer rer afierayfrere Module #§ erga BFA] 2 SIR Creed CTE FCT TRCPACTR FATT RR TAO FOE YE a OTTER CTT fray Rae face BOSS: AT SRT ATEN ATA CEH CTR ed rae TECH Da RIM GH io TRA wa | Gemwearay | eRaied eanTel GemwcaTey Bpcon Aaaie Cea Sc Ices ofan w | cece | GReit satel Gexeonny aR oa ofa Soe repre aera | face fart BSS: OT rest S PICS ACA CHT WHSIATY If Sela ATH, ATA, wIfas, cares | career aa @ Bow Bere wf “ara WER STR CAS CC SHALE ATH, AP, Ifa, CrTaTeeT wo Boke oom afecRT ane ibe cece cwarferera ets sfacai wit ean afer aie for ROR AER, BE, SH SY ACM Ses WATTS Say SoH afar afte cor SFC orSte atera cate STOTISTH, (ota ate Fret a ODT A)