Form 16 (Rule 20)

Application for Refund of Tax

I, .................................................................................................. residing at

...........................................................................................................................

......................................................... owner of Motor Vehicle Registration

Number ..................................... having paid the tax on the said vehicle for

the period ....................................... to .......................................... hereby

claim a refund of tax on the following grounds.

1. That the taxation card in respect of motor vehicle bearing

Registration Number ........................................ was surrendered

on ........................................... together with certificate of

registration.

2. The registration of motor vehicle number ........................................

was refused on ......................................

3. That the motor vehicle number .............................................. is

subject to lower rate of tax.

4. That I have paid more tax than is due from me.

Satisfactory proof of my claim is attached herewith.

Date : Applicant

Note :- Strike out any clause which is not applicable.