NOTICE OF ANNUAL ASSESSMENTS AND REFUND ORDER
FORM-C (See Rules 15 and 17)

To,
            (Dealer)
Take notice that you have been finally assessed under the Andhra Pradesh General Sales Tax Act, 1957, to a 1(tax) of 
Rs. ................................  (Rupees (in words).......................................................................................... only), for the year ending ................................  The total amount of 1(tax) paid by you already is Rs. .............................(Rupees (in words).......................................................................................... only) that is Rs. ............................ in excess of the (tax) due.
2.  Out of the above excess a sum of Rs. ..................................... will be adjusted towards 1 (tax) due from you for the period.
*3   The claim for the amount of refund due shall be made in 1(Form XXIII).  No such claim made after the lapse of three years from the date of this notice will be allowed.
A refund order for the amount of Rs. ................................  is enclosed.
You should apply the Government Treasury at.................................................................... (for the refund of the sum) within  three months from the date of issue of this notice failing which the amount will lapse to the Government.

2[Turnover and total tax payable as determined by the assessing authority in respect of:-
___________________________________________________________________________________________
Commodity            Description            Rate of             3Gross            Exempted             Net            4Tax
code                        of goods                 tax                turnover            turnover          turnover
                                                                                      (a)                    (b)                (a)-(b)
___________________________________________________________________________________________
    1                               2                          3                    4                       5                      6                7
___________________________________________________________________________________________

Place:
Date:                                                                                                                                Assessing Authority
___________________________________________________________________________________________
Note:-    1.    This Form was substituted for the original by G.O.Ms.No.1857, Rev.dt.28.10.1963.  The words and
                     figures 'Form XXIII, were renumbered for 'Form XXVI' by G.O.Ms.No.415 Rev.dt.10.3.1964
                     and the word  "tax" was substituted by 'tax and surcharge on such tax'  by   G.O.Ms.No.473
                     Rev.dt.18.3.1981 and deleted by G.O.Ms.No.244 Rev.dt.17.5.1995. 
              2.    Subs. by G.O.Ms.No.1445, Rev.dt.5.11.1986.
              3.    Subs. by G.O.Ms.No.688, Rev.dt.11.10.1988.
              4.    Subs. by G.O.Ms.No.244 Rev.dt.17.5.1995.