FORM APP
406
APPLICATION
FOR STAY OF COLLECTION OF DISPUTED TAX
[Under Section
31(2) & 33(6) ] [ See Rule 39(1) ]
| 01. Office
Address:
____________________________________________
____________________________________________
____________________________________________
____________________________________________
|
|
|
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| 03. Name:_____________________________________________________________________________________
Address _______________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
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| 04.
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Tax period |
|
| 05.
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Authority passing the order
or proceeding disputed. |
|
| 06
|
Date on which the order or
proceeding was
communicated. |
|
| 07.
|
- (a) Tax assessed
- Penalty / Interest
disputed
|
Rs.
Rs.
Rs. |
| 08
|
Amount for which stay is being
sought |
|
| 09.
|
Address to which the communications
may be sent to the applicant. |
|
|
Signature
of the Dealer(s)
Signature
of the Authorised Representatives if any
VERIFICATION
I / We__________________________________________
applicant (s) do hereby declare that what is stated above is true to
the best of my / our knowledge and belief.
Verified to day the _________
day of_________________200
Signature
of the Dealer(s)
Signature
of the Authorised Representatives if any
NOTE:-
(1)The revision application should be accompanied by the original order
against which it is filed or by a certified copy thereof unless the
omission to produce such order or copy is explained to the satisfaction
of the revisional authority.
(2) The application
should be written in English and should set forth concisely and under
distinct heads the grounds of appeal without any argument or narrative
and such grounds should be numbered consecutively.
The application
should be in duplicate.