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“
GOVERNMENT OF THE PEOPLE’S REPUBLIC OF
Mushak-9.1
BANGLADESH
NATIONAL BOARD OF REVENUE
VALUE ADDED TAX RETURN FORM
[See rule 47(1)]
[Please read the instructions before filling up this form]
Part-1: TAXPAYER’S INFORMATION
1. BIN :
2. Name of Taxpayer :
3. Address of Taxpayer :

4. Type of Ownership :
5. Economic Activity :

( 25659 )
g~j¨ t UvKv 30.00
25660 evsjv‡`k †M‡RU, AwZwi³, wW‡m¤^i 11, 2019
Part-2: RETURN SUBMISSION DATA
1. Tax Period :
2 Type of Return : A) Main/Original Return (Section 64) ☐
[Please select your desired option] B) Late Return (Section 65) ☐
C) Amended Return (Section 66) ☐
D) Full or Additional or Alternative
Return (Section 67) ☐
3 Any activities in this Tax Period? Yes ☐ No ☐
[If Selected “No” Please Fill Only the
relevant Part]
4. Date of Submission :

Part-3: SUPPLY - OUTPUT TAX

Nature of Supply Note Value SD VAT
(a) (b) (c)
Zero Rated Direct Export 1 Sub-form
Goods/Service
Deemed Export 2 Sub-form
Exempted Goods/Service 3 Sub-form
Standard Rated Goods/Service 4 Sub-form
Goods Based on MRP 5 Sub-form
Goods/Service Based on Specific VAT 6 Sub-form
Goods/Service Other than Standard Rate 7 Sub-form
Retail/Wholesale/Trade Based Supply 8 Sub-form
Total Sales Value & Total Payable 9
Taxes

Part-4: PURCHASE - INPUT TAX

1) If all the products/services you supply are standard rated, fill up note 10-20.

2) All the products/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.
 evsjv‡`k †M‡RU, AwZwi³, wW‡m¤^i 11, 2019 25661

Nature of Purchase Note Value VAT

(a) (b)
Zero Rated Local Purchase 10 Sub-form
Goods/Service Import 11 Sub-form
Exempted Local Purchase 12 Sub-form
Goods/Service Import 13 Sub-form
Standard Rated Local Purchase 14 Sub-form
Goods/Service Import 15 Sub-form
Goods/Service Other Local Purchase 16 Sub-form
than Standard Rate Import 17 Sub-form
Goods/Service Based Local Purchase 18 Sub-form
on Specific VAT
Goods/Service Not From Turnover 19 Sub-form
Admissible for Credit Tax Units
(Local Purchase) From 20 Sub-form
Unregistered
Entities
Goods/Service Not Local Purchase 21 Sub-form
Admissible for Credit Import 22 Sub-form
(Taxpayers who sell
only Exempted/
Specific VAT and
Goods/Service Other
than Standard Rate/
Credits not taken
within stipulated
time)
Total Input Tax Credit 23

Part-5: INCREASING ADJUSTMENTS (VAT)

Adjustment Details Note VAT Amount
Due to VAT Deducted at Source by the supply 24 Sub-form
receiver
Payment Not Made Through Banking Channel 25
Issuance of Debit Note 26
Any Other Adjustments (please specify below) 27

Total Increasing Adjustment 28

25662 evsjv‡`k †M‡RU, AwZwi³, wW‡m¤^i 11, 2019

Part-6: DECREASING ADJUSTMENTS (VAT)

Adjustment Details Note VAT Amount
Due to VAT Deducted at Source from the 29 Sub-form
supplies delivered
Advance Tax Paid at Import Stage 30 Sub-form
Issuance of Credit Note 31
Any Other Adjustments (please specify below) 32

Total Decreasing Adjustment 33

Part-7: NET TAX CALCULATION

Items Note Amount
Net Payable VAT for the Tax Period (Section- 45) 34
( 9C-23B+28-33)
Net Payable VAT for the Tax Period after Adjustment 35
with Closing Balance and balance of form 18.6 [34-
(52+56)]
Net Payable Supplementary Duty for the Tax Period 36
(Before adjustment with Closing Balance)
[9B+38-(39+40)]
Net Payable Supplementary Duty for the Tax Period 37
after Adjusted with Closing Balance and balance of
form 18.6 [36-(53+57)]
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) 41
Interest on Overdue SD (Based on note 37) 42
Fine/Penalty for Non-submission of Return 43
Other Fine/Penalty/Interest 44
Payable Excise Duty 45
Payable Development Surcharge 46
Payable ICT Development Surcharge 47
Payable Health Care Surcharge 48
Payable Environmental Protection Surcharge 49
Net payable VAT for treasury deposit 50
( 35+41+43+44)
Net payable SD for treasury deposit ( 37+42) 51
Closing Balance of Last Tax Period (VAT) 52
Closing Balance of Last Tax Period (SD) 53
 evsjv‡`k †M‡RU, AwZwi³, wW‡m¤^i 11, 2019 25663

Part-8: ADJUSTMENT FOR OLD ACCOUNT CURRENT BALANCE

Items Note Amount
Remaining Balance (VAT) from Mushak-18.6, 54
[ Rule 118(5)]
Remaining Balance (SD) from Mushak-18.6, 55
[ Rule 118(5)]
Decreasing Adjustment for Note 54 (up to 10% 56
of Note 34)
Decreasing Adjustment for Note 55 (up to 10% 57
of Note 36)

Part-9: ACCOUNTS CODE WISE PAYMENT SCHEDULE

(TREASURY DEPOSIT)
Items Note Account Amount
Code
VAT Deposit for the Current 58 Sub-form
Tax Period
SD Deposit for the Current 59 Sub-form
Tax Period
Excise Duty 60 Sub-form
Development Surcharge 61 Sub-form
ICT Development Surcharge 62 Sub-form
Health Care Surcharge 63 Sub-form
Environmental Protection 64 Sub-form
Surcharge

Part-10: CLOSING BALANCE

Items Note Amount
Closing Balance (VAT) [58 - (50 + 67) + The 65
refund amount not approved]
Closing Balance (SD) [59 - (51 + 68) + The 66
refund amount not approved]

Part-11:REFUND
I am interested to get refund of my Items Note Yes ☐ No ☐
Closing Balance
Requested Amount 67
for Refund (VAT)
Requested Amount 68
for Refund (SD)
25664 evsjv‡`k †M‡RU, AwZwi³, wW‡m¤^i 11, 2019

Part-12: DECLARATION
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.
Name :
Designation :
Mobile Number :
National ID/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, 21 and 22)
Serial Goods / Goods / Goods / Value SD VAT Notes
No. Service Service Service (a) (b) (c)
Commercial Code Name
Description

TOTAL
Sub-form: (For Note - 6 and 18)
Serial Goods / Goods / Goods / Unit of Quantity Actual Sales / SD VAT Notes
No. Service Service Service Measure (b) Purchases (d) (e)
Commercial Code Name (a) Value
Description (c)

TOTAL

Sub-form ( For Note - 8)

Serial Category Goods /Service Goods / Goods / Value SD VAT Notes
No. Commercial Service Service (a) (b) (c)
Description Code Name

1 Commercial Importer/
Other traders
2 Petroleum product
3 Super-shop
4 Medicine related
products

TOTAL
Sub-form (For Note - 24)
Serial Supplier’s Supplier’s Supplier’s Value Deducted Invoice No./ Invoice/ VAT VAT Tax Tax deposit Tax Notes
No. BIN Name Address VAT Challan/ Bill Challan/ Deduction Deduction deposit serial deposit
No. etc.) Bill Date at source, at source, Account number of date
Certificate Certificate Code Book
No date transfer

evsjv‡`k †M‡RU, AwZwi³, wW‡m¤^i 11, 2019

TOTAL

Sub-form: (For Note - 29)

Serial Buyer’s Buyer’s Buyer’s Value Deducted Invoice Invoice/ VAT VAT Tax Tax Tax Notes
No. BIN Name Address VAT No./ Challan/ Deduction Deduction deposit deposit deposit
Challan/ Bill Date at source, at source, Account serial date
Bill No. Certificate Certificate Code number
etc.) No date of Book
transfer

TOTAL

25665
25666 evsjv‡`k †M‡RU, AwZwi³, wW‡m¤^i 11, 2019
Sub-Form : (For Note - 30)
Serial Bill of Entry Date Custom Advance Notes
No. Number House/Customs Tax
Station Amount

TOTAL

Sub-form ( For Note - 58,59,60,61,62,63 and 64)

Serial Treasury Bank Branch Date Tax Amount Notes

Challan Deposit
No.
Number Account
Code

TOTAL

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