Appeal to Appellate Authority

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..... rges (v) Market value of seized goods 10. Whether the appellant wishes to be heard in person - Yes/No 11. Statement of facts :- 12. Grounds of appeal :- 13. Prayer :- 14. Amount of demand created, admitted and disputed Particulars of demand/refund Particulars Central tax State/UT tax Integrated tax Cess Total amount Amount of demand created (A) (a) Tax/Cess total total (b) Interest total (c) Penalty total (d) Fees total (e) Other charges total Amount of demand admitted (B) (a) Tax/Cess total total (b) Interest total (c) Penalty total (d) Fees total (e) Other charges total Amount of demand disputed (C) (a) Tax/Cess total total (b) Interest total (c) Penalty total (d) Fees total (e) Other charges total 1 [ 15. Details of payment of admitted a .....

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..... of supply wise details of the integrated tax paid (admitted amount only) mentioned in the Table in sub-clause (a) of clause 15 (item (a)), if any Place of Supply (Name of State/UT) Demand Tax Interest Penalty Other Total 1 2 3 4 5 6 7 . Admitted amount [in the Table in sub-clause (a) of clause 15 (item (a))] ] Verification I, ______________________________ , hereby solemnly affirm and declare that the information given hereinabove is true and correct to the best of my knowledge and belief and nothing has been concealed therefrom. Place : Date : Signature Name of the Applicant : ************ NOTES:- 1. Substituted vide Notification No. 03/2019-Central Tax dated 29-01-2019 w.e.f. 01-02-2019 before it was read as 15. Details of payment of adm .....

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..... r cess, or not exceeding ₹ 50 crore in respect of IGST and ₹ 25 crore in respect of cess) Tax/Cess total 4. Substituted vide Notification No. 20/2024 Central Tax dated 08-10-2024 w.e.f. 01-11-2024 before it was read as, (b) Pre-deposit (10% of disputed tax /cess but not exceeding ₹ 25 crore each in respect of CGST, SGST or cess, or not exceeding Rs. 50 crore in respect of IGST and ₹ 25 crore in respect of cess) 5. Substituted vide Notification No. 20/2024 Central Tax dated 08-10-2024 w.e.f. 01-11-2024 before it was read as, (pre-deposit 10% of the disputed tax and cess but not exceeding ₹ 25 crore each in respect of CGST, SGST or cess, or not exceeding ₹ 50 crore in respect of IGST and ₹ 25 crore in .....

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