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Republic of Namibia |
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Ministry of Finance Inland Revenue |
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VAT Refunds to Foreign Tourists Claim Form |
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Particulars of claimant: |
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Name: |
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Nationality: |
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Passport number: |
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Bank Branch address and code number: |
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Bank account number: |
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Particulars of goods: |
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Supplier name and address: |
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Tax invoice no. and date: |
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Description of goods: |
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Total value of goods (including VAT): N$ |
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Amount of VAT clamed: N$ |
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Declaration and claim: |
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described above which I am exporting from Namibia and that I do not hold a Namibian passport. I wish to claim a refund of: |
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N$ VAT in the following currency: S.A. Rand/US$/Euro/Pounds stg. (delete as appropriate) |
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Signed Date: |
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For official use only |
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Certified that the goods have been exported |
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Customs Officer Date Stamp |
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Claim received by Inland Revenue: |
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Checked and approved: |
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