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THE ODISHA GOODS AND SERVICES TAX FORMS 2017
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FORM GST APL-01/03 W

[See rule 109C]

Application for Withdrawal of Appeal Application

1. GSTIN:

2. Name of Business (Legal) (in case appeal is filed under sub-section (1) of section 107)

3. Name and designation of the appellant (in case appeal is filed under sub-section (2) of section 107):

4. Order No.& Date:

5. ARN of the Appeal & Date:

6. Reasons for Withdrawal:-

    i. Acceptance of order of the adjudicating authority.

    ii. Acceptance of order of a Higher Appellate Authority/ Court on similar subject matter

    iii. Need to file appeal again after rectification of mistakes/omission in the filed appeal

    iv. Amount involved in appeal is less than the monetary limit fixed for Appeal by the Board/Commissioner

    v. Any other reason

7. Declaration (applicable in case appeal is filed under sub-section (1) of section 107):

I/We <Taxpayer Name> hereby solemnly affirm and declare that the information given herein is true and correct to the best of my/ our knowledge and belief and nothing has been concealed therefrom.

Place: Signature
   
Date: Name of Applicant /Applicant Officer
  Designation/ Status.".