Form GSTR-5 (See Rule.)

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Form GSTR-5 (See Rule.) Return for Non-resident taxable person Year Month 1. GSTIN 2. (a) Legal name of the registered person Auto Populated (b) Trade name, if any Auto Populated (c) Validity period of registration Auto Populated 3. Inputs/Capital goods received from Overseas (Import of goods ( in Rs. for all Tables) Details of bill of entry able of ITC available Rate No. Date Value Integrated Integrated 7 8 9 4. Amendment in the details furnished in any earlier return Original details Revised details Differential ITC (+/_) Bill of entry Bill of entry Rate able of ITC available No Date No Date Value Integrated Integrated Integrated tax 7 8 9 10 11 12 13 5. able outward supplies made to registered persons (including UIN holders) GSTIN/ UIN Invoice details Rate able No. Date Value Integrated Central State / UT Supply (Name of State) 7 8 9 10 11 36

6. able outward inter-state supplies to un-registered persons where invoice is more than Rs 2.5 lakh Supply (State) Invoice details Rate able Value No. Date Value Integrated 1 2 3 4 5 7 8 9 7. able supplies (net of debit notes and credit notes) to unregistered persons other than the supplies mentioned at Table 6 Rate of tax Total able Integrated Central State /UT 7A. Intra-State supply (Consolidated, rate wise) 7B. Inter-State Supplies where the of invoice is upto Rs 2.5 Lakh [Rate wise] Supply (Name of State) 8. Amendments to taxable outward supply details furnished in returns for earlier tax periods in Table 5 and 6 [including debit note/credit notes and amendments thereof] Details of original document Revised details of document or details of original Debit/Credit Notes Rate able Value GSTIN No. Date GSTI No. Date Value Integrated Central State / N UT 7 8 9 10 11 12 13 14 8A. If the invoice details furnished earlier were incorrect 8B. Debit Notes/Credit Notes [original)] 8C. Debit Notes/Credit Notes [amendment of debit notes/credit notes furnished in earlier tax periods] supply 9. Amendments to taxable outward supplies to unregistered persons furnished in returns for Earlier tax periods in Table 7 Rate of tax Total taxable Integrated Central State / UT period for which the details are being revised 9A. Intra-State Supplies [Rate wise] 9B. Inter-State Supplies [Rate wise] Supply (Name of State) 37

10. Total tax liability of tax Rate of able Integrated Central State/UT CESS 10A. On account of outward supply 10B. On account of differential ITC being negative in Table 4 11. payable and paid Description payable Paid in cash Paid through ITC Paid Integrated tax (e) Integrated (f) Central (g) State/UT (h) 12. Interest, late fee and any other amount payable and paid Description payable paid 1 2 3 (II) Interest on account of (b) Integrated tax (b) Central (c) State/UT Late fee on account of (a) Central tax (b) State / UT tax 13. Refund claimed from electronic cash ledger Description Interest Penalty Fee Other Debit Entry Nos. 7 (b) Integrated tax (b) Central (c) State/UT Bank Account Details (Drop Down) 14. Debit entries in electronic cash/credit ledger for tax/interest payment [to be populated after payment of tax and submissions of return] Description paid in cash paid through ITC Interest Late fee Integrated tax (a) Integrated tax (b) Central (c) State/UT 38

Verification I hereby solemnly affirm and declare that the information given herein above is true and correct to the best of my knowledge and belief and nothing has been concealed therefrom. Signatures of Authorized Signatory Place Date. Name of Authorized Signatory. Designation /Status 39

Instructions:- 1. Terms used: a. GSTIN: Goods and Services Identification Number b. UIN: Unique Identity Number c. UQC: Unit Quantity Code d. HSN: Harmonized System of Nomenclature e. POS: Supply (Respective State) f. B to B: From one registered person to another registered person g. B to C: From registered person to unregistered person 2. GSTR-5 is applicable to non-resident taxable person and it is a monthly return. 3. The details in GSTR-5 should be furnished by 20 th of the month succeeding the relevant tax period or within 7 days from the last date of the registration whichever is earlier. 4. Table 3 consists of details of import of goods, bill of entry wise and taxpayer has to specify the amount of ITC eligible on such import of goods. 5. Recipient to provide for Bill of Entry information including six digits port code and seven digits bill of entry number. 6. Table 4 consists of amendment of import of goods which are declared in the returns of earlier tax period. 7. Invoice-level information, rate-wise, pertaining to the tax period separately for goods and services should be reported as under: i. For all B to B supplies (whether inter-state or intra-state), invoice level details should be uploaded in Table 5; ii. For all inter-state B to C supplies, where invoice is more than Rs. 2,50,000/- (B to C Large) invoice level detail to be provided in Table 6; and iii. For all B to C supplies (whether inter-state or intra-state) where invoice is up to Rs. 2,50,000/- State-wise summary of supplies shall be filed in Table 7. 8. Table 8 consists of amendments in respect of - i. B2B outward supplies declared in the previous tax period; ii. B2C inter-state invoices where invoice is more than 2.5 lakhs reported in the previous tax period; and iii. Original Debit and credit note details and its amendments. 9. Table 9 covers the Amendments in respect of B2C outward supplies other than inter-state supplies where invoice is more than Rs 250000/-. 10. Table 10 consists of tax liability on account of outward supplies declared in the current tax period and negative ITC on account of amendment to import of goods in the current tax period. On submission of GSTR-5, System shall compute the tax liability and ITC will be posted to the respective ledgers. 40