Taxpayer Details

Acknowledgement Date *
Refund For Application Type	--Select-- Motor Vehicle Driving Permit Stamp Duty	Vehicle Registration Number
Refund Claim details Total Refund Amount *   Refund For * -----Select---- Assessment No Payment Registration No Number * Amount *
Sr No. Refund For Number Amount Delete Total Amount : 0.00
1) TIN

2) Taxpayer Details (Individual)
Title	--Select--	If other specify
Surname*		First Name*
Middle Name		Acquired Name
Family Surname		Date of Birth*
Sex/Gender*	Male   Female
3)  Taxpayer Details (Non Individual)
4) Address of Owner
Plot Number		Street Name
Building Name		District*	--Select--
County*	--Select--	Sub-County*	--Select--
Parish*	--Select--	Village*	--Select--
Trading Center*
P.O. Box No		Town City	--Select-- ABIM ADJUMANI AGAGO ALEBTONG AMOLATAR AMUDAT AMURIA AMURU APAC ARUA BUDAKA BUDUDA BUGIRI BUHWEJU BUIKWE BUKEDEA BUKOMANSIMBI BUKWO BULAMBULI BULIISA BUNDIBUGYO BUNYANGABU BUSHENYI BUSIA BUTALEJA BUTAMBALA BUTEBO BUVUMA BUYENDE DOKOLO GOMBA GULU HOIMA IBANDA IGANGA ISINGIRO JINJA KAABONG KABALE KABAROLE KABERAMAIDO KAGADI KAKUMIRO KALANGALA KALIRO KALUNGU KAMPALA KAMULI KAMWENGE KANUNGU KAPCHORWA KASESE KATAKWI KAYUNGA KIBAALE KIBOGA KIBUKU KIRUHURA KIRYANDONGO KISORO KITGUM KOBOKO KOLE KOTIDO KUMI KWEEN KYANKWANZI KYEGEGWA KYENJOJO KYOTERA LAMWO LIRA LUUKA LUWEERO LWENGO LYANTONDE MANAFWA MARACHA MASAKA MASINDI MAYUGE MBALE MBARARA MITOOMA MITYANA MOROTO MOYO MPIGI MUBENDE MUKONO NAKAPIRIPIRIT NAKASEKE NAKASONGOLA NAMAYINGO NAMISINDWA NAMUTUMBA NAPAK NEBBI NGORA NTOROKO NTUNGAMO NWOYA OMORO OTUKE OYAM PADER PAKWACH PALLISA RAKAI RUBANDA RUBIRIZI RUKIGA RUKUNGIRI SERERE SHEEMA SIRONKO SOROTI SSEMBABULE TORORO WAKISO YUMBE ZOMBO
5) Other Details
Landline Number		Mobile Phone Number*
Email Address

Refund Details

Reason for Refund Claim *
Bank Details For Refund Purposes
Name of Bank *	--Select-- ABC Capital Bank Limited ANY ANY Dummy Bank Absa Bank Uganda Limited African Alliance Investment Bank Allied Bank International BRAC UGANDA BANK LIMITED Bank Of Africa Bank Of Baroda Bank Of India Uganda Limited Bank Of Uganda Cairo International Bank Capital Finance Corporation Ltd. Centenary Bank Citibank Co-Operative Bank Commercial Micro Finance Ltd Continental Trust Bank Crane Bank Dfcu Bank Diamond Trust Bank Dyer & Blair Investment Bank ECB Dummy Bank East African Development Bank Eco Bank Equity Bank Uganda Limited Exim Bank Uganda Limited FINANCE TRUST BANK FINCA UGANDA LIMITED Finance Division Finance Trust Bank Limited GTBank Global Trust Bank Limited Gold Trust Bank Greenland Bank Gross Domestic Payment Account Housing Finance Housing Finance Bank Imperial Investment Finance International Credit Bank Ltd KCB Bank Uganda Mengo Teachers T & L Co-Op . Merchant Bank Of East Africa NC Bank Uganda Limited NCBA BANK UGANDA LIMITED National Bank Of Commerce Nile Bank OPPORTUNITY BANK UGANDA LIMITED Orient Bank Post Bank Uganda Limited Premier Building Society Pride Microfinance Uganda LTD Renaissance Capital Investment Bank Stanbic Standard Chartered Stanhope Finance Co. Ltd Teefe Trust Bank Transafrica Bank Tropical Bank Ltd Trust Bank Uganda Development Bank United Bank For Africa Ura
Bank Branch *	--Select--
Account Number(only UGX Accounts) *
Fields marked with * are mandatory

Attachments

Attachment(s)
Bank Slip	Assessment Slip
Enter text from Given the image*	Try Another (Letters are case sensitive)

Fields marked with * are mandatory

Errors

Sr. No.	Error Description