Form No- FA/AF/2022/3/E

AFFIDAVIT OF GRANTING CONSENT OF BUSINESS ACTIVITY

I…………………………………………………………………………………………………………………………………………………., (Full Name)

the………………………………………………………………… (Official Designation) of………………………………………………………….
(Business Name). I am submitting this affidavit to the Inland Revenue Department as evidence of authority
of …………………………………………………………………… (Business Entity)

I hereby swear/ affirm under penalty of perjury that the information set forth below is true, correct and
accurate.

1. The full legal name of the business is ………………………………………………………………………………………………….

2. The entity is a taxpayer of the Inland Revenue Department, Sri Lanka

3. The entity’s Tax Identification Number (TIN) is …………………………………………………………………………………..

4. I as authorized by the entity- grant my consent, I do not have any refund / I have only following
refunds to set off which has been arisen as at September 15, 2021 from any tax return with respect
to any tax administered by the Commissioner General of Inland Revenue and submitted by the
entity up to any period ending prior to December 31, 2020 against any tax arrears and my consent
to refund the Company the residual refund if any

Tax Type Tax Period Refund Claimed

5. Further, I assure that the Company will not make any refund claim afresh in relation to any period
ending prior to December 31, 2020 through amending the Returns or requesting for payment
transfers or any other means.

Date: Signature of Affiant

Legal Title of Affiant

SUBSCRIBED AND SWORN BEFORE ME this …………………………..day of 2022.

Commissioner for Oaths/ Justice of Peace