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THE JAMMU AND KASHMIR GOODS AND SERVICES TAX FORMS 2017
APPEAL AND REVISION

Body

Form GST APL - 04

[Refer Rule 113(1) & 115]

Summary of the demand after issue of order by the Appellate Authority, Tribunal or Court

Order no. - Date of order -

1. GSTIN/ Temporary ID/UIN -    
2. Name of the appellant-    
3. Address of the appellant-    
4. Order appealed against- Number- Date-
5. Appeal no. Date-  
6. Personal Hearing -    
7. Order in brief-    
8. Status of order- Confirmed/Modified/Rejected    
9. Amount of demand confirmed:    

Particulars

Central tax State/UT tax Integrated tax Cess Total
Disputed Amount Determined Amount Disputed Amount Determined Amount Disputed Amount Determined Amount Disputed Amount Determined Amount Disputed Amount Determined Amount
1 2 3 4 5 6 7 8 9 10 11
a) Tax                    
b) Interest                    
c) Penalty                    
d) Fees                    
e) Others                    
f) Refund                    

10. Details of IGST Demand

Place of Supply (Name of State/UT) Demand Tax Interest Penalty Other Total

1 2 3 4 5 6 7
  Disputed Amount          
  Determined Amount          

Place:  
Date:  
 
< Signature>

 

  < Name of the Appellate Authority>
  Jurisdictional Officer>
  Designation:
  Jurisdiction: