Form 4 - Form 4 - Indirect Tax Dispute Resolution Scheme Rules, 2016

Form 4 [See rule 5(1)] FORM OF ORDER OF DISCHARGE OF DUES UNDER SUBSECTION (4) SECTION 214 OF THE FINANCE ACT, 2016 (28 of 2016). Reference No Mr/ Mrs/ M/s .......................................................(Name and address of the declarant) (hereinafter referred to as declarant) had made a declaration under sub-section (1) of section 214 of the Finance Act, 2016 (28 of 2016) on ..; and The designated authority by acknowledgement of even number in Form 2 dated .............. acknowledged the said declaration; The Declarant has intimated as required under sub-section (3) of Section 214, the details of amount deposited by him against the said order in original in Form 3 dated . Now, therefore, in exercise of the powers conferred by sub-section (4) of section 214 read with section 216 of the Finance Act, 2016, the designated authority hereby issues order of discharge of due the said declarant (a) certifying the receipt of payment from the declarant towards full and final settlement of the amounts due from the declarant in terms of order in original No . dated .; (b) granting immunity, from all from all proceedings under the Act, in respect of the indirect tax dispute for which the declaration has been made under this Scheme. Signature of the designated authority Place Name of the designated authority Date Official Seal of the designated authority Copy To (1) The declarant (2) Assessing/Adjudicating Officer (3) Commissioner of Customs/ Central Excise/ Service Tax (4) Concerned appellant authorities F No 1080/06/DLA/IDRS/2016 (M.R.Farooqui) Under Secretary to Government of India