FORM - II

Form of Appeal Memorandum to the Appellate Tribunal

(See Rule 9(1)(i))

Appeal Memorandum to the Appellate Tribunal

In the Appellate Tribunal, Andhra Pradesh.

No.____________________________ of 20________

 

                                                                                                 Petitioner ____________________________ 
                                                                              Versus
                                                                                                 Respondent _________________________                                                                                                 

(1) District in which assessment was made. :


(2) Assessment Year :

(3) Authority passing the original order in dispute :

(4) Appellate Deputy Commissioner of Commercial
Taxes passing the order under Section 13(3) or
the Deputy Commissioner or Joint Commissioner/ :
Additional Commissioner passing an order under
Section 14(2).

(5) Date of Communication of the order now
appealed against. :

(6) Address to which notices may be sent to
the appellant :


(7) Address to which notices may be sent to
the respondent :

(8) Relief claimed in appeal :

(a) Purchase value as determined by the
assessing authority passing the assessment
order disputed :

(b) Purchase value as confirmed by the
Appellate Deputy Commissioner of
Commercial Taxes or by Deputy
Commissioner or Joint Commissioner/
Additional Commissioner as the case
may be. :

(c) If purchase value is disputed –

(i) Disputed value :

(ii) Tax due on the disputed value :

(d) If rate of tax is disputed

(i) Purchase value involved :

(ii) Amount of the tax :

(e) Specify, if any, other relief claimed. :

(9) Grounds of appeal etc., :
(attach additional sheet if necessary)

(Signed) Appellant(s)  
(Signed) Authorised Representative, if any
VERIFICATION

I/We ___________________________________________________________________________ the appellant(s) do hereby declare that what is stated above is true to the best of my/our knowledge and belief.
Verified today the   ______________ day of ____________________________ 20______

(Signed) Appellant(s)  
(Signed) Authorised Representative, if any

Note:

1.The appeal should be in quadruplicate and should be accompanied by four copies (atleast one of which should be the original or an authenticated copy) of the order appealed against and also three copies of the order of the assessing authority.

2.The appeal shall be accompanied by a Treasury receipt in support of having paid of a fee calculated at the rate of two percent of the disputed tax or penalty subject to a minimum of Rs.100/- and maximum of Rs.2000/- in cases where the levy of tax is disputed and fee of Rs.100/- in all other cases.  The fee should be credited in a Government Treasury to the following Head of account:
  "_________________________________"

3.The appeal should be written in English and should set forth concisely and under distinct heads the grounds of appeal without any argument or narrative and such grounds should be numbered consecutively.