Appeal to the Joint Commissioner (Appeals) or the Commissioner of Income-tax (Appeals)

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..... Country (Select) Pin Code Phone No. with STD code/ Mobile No. Email Address Whether notices/ communication may be sent on email? Yes/ No Order against which Appeal is filed 1 Assessment year in connection with which the appeal is preferred/ Enter financial year in case appeal is filed against an order where assessment year is not relevant Assessment Year Financial Year 2 Details of the order appealed against a Section .....

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..... Appeal Details 5 Section and sub-section of the Income-tax Act,1961 under which the appeal is preferred 6 If appeal relates to any assessment a Amount of Income Assessed (in Rs.) b Total Addition to Income (in Rs.) c In case of Loss, total disallowance of Loss in assessment (in Rs.) d Amount of Addition/ Disallowance of Loss disputed in Appeal (in Rs.) .....

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..... Date of payment Sl. No. Amount Total 10 If the appeal relates to any tax deductible under section 195 of the Income-tax Act, 1961 and borne by the deductor, details of tax deposited under section 195(1) BSR Code Date of payment Sl. No. Amount .....

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..... 16 Details of Appeal Fees Paid BSR Code Date of payment Sl. No. Amount 17 Address to which notices may be sent to the appellant Form of verification I, ____________________________the appellant, do hereby declare that what is stated above is true to the best of my information and .....

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