Application for settlement of a case under section 32E of Excise Act made applicable to service tax vide section 83 of the Finance Act, 1994 (32 of 1994)

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..... munication: (ii) Telephone No. 4. (i) Permanent Account No: (ii) Service Tax registration No: (iii) Status: (See note 2) 5. (i) Commissioner of Central Excise/Service Tax having jurisdiction over the applicant: (ii) Postal address of the Commissioner of Central Excise/Service Tax having jurisdiction over the applicant: 6. Details of Show Cause Notice issued to the applicant (a) Show Cause Notice No and date (b) Period of dispute in the notice (c) Service tax demanded in the notice ( in Rs. ) (d) Dispute in connection with which the application for settlement is made. (e) .....

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..... (ii) Details of deposit of settlement amount (iii) Whether settlement amount has been paid in terms of the order (e) If any application of the applicant was sent back/rejected by the Settlement Commission, the reference number and date of the order (f) Reference number and date of the order, if any, in case the applicant was convicted of any offence under Chapter V of the Act in relation to a case settled earlier by the Settlement Commission 12. (i) Details of the order, if the applicant was ever debarred from making further application for settlement under section 32-O of Excise Act made applicable to Service Tax vide section 83 of the Act, by any of the Benc .....

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..... judicating authority by the said appellate authorities. Verified today the ..day of .(mention the month and year) at (mention the place) Deponent Note: 1. The application fee should be credited in a branch of the authorised bank or a branch of the State Bank of India or a branch of Reserve Bank of India and the triplicate copy of the challan sent to the Settlement Commission with the application. The Settlement Commission will not accept cheques, drafts, hundies or other negotiable instruments. 2. Please state whether individual, Hindu undivided family, company, firm, an association of persons, etc. 3. Details of the additional amount of Service Tax accepte .....

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