FORM ST-5
- Document type
- Form
- Dated
- Category
- Form & Annexure
Form of Appeal to Appellate Tribunal under section 86 of the Finance Act, 1994 ( 32of 1994 )
FORM ST – 5
Form of Appeal to Appellate Tribunal under section 86 of the Finance Act,
1994 ( 32of 1994 )
In the Customs, Excise and Gold (Control) Appellate Tribunal Appeal No. _________ of ______ 20________
______________________________________ Appellant
v.
____________________________________ Respondent
- The designation and address of the authority
passing the order appealed against. - The number and the date of the order
appealed against. - Date of communication of a copy of the
order appealed against. - State / Union territory and the
Commissionerate in which the order / decision
of assessment / penalty /
interest was made. - Designation and address of the
adjudicating authority in cases
where the order appealed against
is an order of the Commissioner
(Appeals) - Address to which the notices may be sent
to the appellant. - Address to which the notices may be sent
to the respondent. - Whether the decision or order appealed against
involved any question having a relation to the
value of the taxable service for purposes of
assessment; if not , difference in tax or tax
involved, or amount of interest or penalty
involved, as the case may be.
- (i) Period of dispute
(ii) Amount of tax if any, demanded for the
period mentioned in item (i)
(iii) Amount of refund, if any, claimed for the
period mentioned in item (i)
(iv) Amount of interest involved.
(v) Amount of penalty imposed.
- Whether tax or penalty / interest is deposited;
if not, whether any application for dispensing
with such deposit has been made ( a copy of
the challan under which the deposit is made
shall be furnished).
10. Reliefs claimed in appeal.
Grounds of appeal
(ii)
(iii)
(iv)
| Signature of the authorized representative, if any | Signature of the appellant |
I,______________________ the appellant, do hereby declare that what is stated above is true to the best of my information and belief.
- Verified today, the ____________________ day of ______20_____
Place:
Date :
| Signature of the authorized representative, if any | Signature of the appellant or his authorized representative |
Note :-
- (1)The appeal including the statement of facts and the grounds of appeal shall be filed in quadruplicate and shall be accompanied by an equal number of copies of the order appealed against (one of which at least shall be a certified copy).
(2) The form of appeal shall be in English (or Hindi) and should set forth, concisely and under distinct heads, the grounds of appeal without any argument or narrative and such grounds be numbered consecutively.
(3) The fee of Rs. 200 required to be paid under the provisions of the Act shall be paid through a crossed bank draft in favour of the Assistant Registrar of the Bench of the Tribunal on a branch of any nationalised bank located at the place where the Bench is situated and demand draft shall be attached to the form of appeal.