FORM lA
(See Rule 33(2)(iv) of A.P.G.S.T. Rules, 1957)
Declaration

 
To
The Appellate Deputy Commissioner

______________________________

I/We,___________________________________________________________Son/Daughter/Wife of ____________________________________________________ appellant is named in the appeal preferred herein as____________________________________________________________(Dealer Name/Firm Name), an assessee on 
the rolls of ______________________with Registration Number ___________________________________ hereby declare 
that the tax admitted to be due, or of such instalments as have been granted have been paid, for the relevant assessment year, in respect of which the appeal is preferred, the details of which are given below.  I hereby declare that no arrears are
due from me the above-mentioned firm for the relevant year for which appeal is preferred.

1.       Total Tax paid:

             a)  Cheque/DD particulars

                          Number      :                                                     Date :

                          Bank      :                                                           Branch :

            
    b) Cash (Receipt No.) if paid

                                 Receipt No.:                                                            Date:

            c) Challan particulars:

                          Number      :                                                           Date:
                          Name of Treasury      :

                                                                                                                                                                                                  Signature

                                                                                                                                                                       Status and  relationship to thedealer