Form-3 - Intimation of payment under sub-section (2) of section 92 of finance (no. 2) act, 2024 - Direct Tax Vivad Se Vishwas Rules, 2024

Form-3 [ See rule 6 ] INTIMATION OF PAYMENT UNDER SUB-SECTION (2) OF SECTION 92 OF FINANCE (NO. 2) ACT, 2024 (UNDER THE DIRECT TAX VIVAD SE VISHWAS SCHEME, 2024) To, The Designated Authority ............................................ ............................................ Sir/Madam, 1. Pursuant to the certificate received from designated authority in Form-2 vide certificate No.____________ dated _____ in respect of ________________________________________________________ (Name of the declarant) ____________ PAN and____________ TAN(mandatory if TAN based appeal), for A.Y.____________ and F.Y.(to be furnished only if TAN based appeal)____________ , for the Appeal Reference Number (add row)____________ and Date of Filing Appeal (add row)_____________, the detail of payments made is as under: Sl. BSR Code of Bank Date of Deposit (DD/MM/YYYY) Serial Number of Challan Amount (Rs) (1) (2) (3) (4) (5) 2. The appeal, objections, application, writ petition, special leave petition, or claim has been withdrawn (please upload proof of withdrawal). Place: .. Date: .. .. Signature/Verification