Rule Form 3 - Form 3 - Indirect Tax Dispute Resolution Scheme Rules, 2016

Form 3 [See rule 4(2)] FORM OF REPORTING THE PAYMENT UNDER SUB SECTION (3) OF SECTION 214 OF THE FINANCE ACT, 2016 (28 OF 2016) IN RESPECT OF INDIRECT TAX DISPUTE RESOLUTION SCHEME, 2016 [IN DUPLICATE] To, The Designated Authority ............................................ . Sir/Madam, Please refer to the declaration made by me in Form 1 dated ., and the acknowledgement issued by you in Form 2, vide your Reference No . dated As required I have deposited the amounts as follows on . Amount as per order in original Amount deposited Duty Interest Penalty Copy of the Challan dated .. for making the payment as above are enclosed. Place .. Signature of person making declaration . Date .. Name of person making declaration .