FORM XI

(See rule 7(4)]

Memorandum of appeal against an order of security deposit under sub-section (3H) of section 7 of the Central Sales Tax Act, 1956

Appeal No. ............................. of............................................

Period to which the appeal relates ..............................................

Date of receipt by the appellate authority .....................................

Initials of the appellate authority.................................................

To

The .................................. of Commercial Taxes,

........................................ Circle/ Sub-circle,

I ............................................................., son of ........................................................ hereby prefer this

appeal against the order, dated ................. passed by .................. and furnish the following particulars for that purpose:

1. Name and address of the dealer

2. Name and Style of the business

3. Status of the dealer

(Write here individual, undivided Hindu family, firm, company, corporation, association, society, club, local authority, Government department, etc., as the case may be)

4. Registration No.

5. Location of the place of business

6. Address to which communication should ordinarily, be despatched (to be filled up only if this is different from the address mentioned in item 1) -

(a) Mohalla / Road

(b) Village / Town

(c) Post Office

(d) Police Station

(e) Sub-division

7. Period to which appeal relates

8. Date of service of demand notice

9. Details of turnover and tax assessed for the year

(a) Gross turnover

(b) Taxable turnover

(c) Total amount of security/additional security demanded

(d) Total amount of tax assessed or reassessed during the year

10. Amount in dispute -

(a) Tax

(b) Security/additional security

11. List of papers and documents filed -

(a) Challan No.......... date ............. For Rs............. Showing deposit of fee payable on this memorandum of appeal

(b) Certified copy of the order appealed against, together with the notice of demand

(c) Challan No............. date ............ for Rs............. Showing deposit of security/additional security amount or proof of deposit of security by other means as mentioned in 8A (4)

(d) Three extra copies of this memorandum

12. Statement of facts of the case and prayer -

(a) The facts of the case are as follows: -

(b) The points at issue are as follows: -

(c) Grounds of appeal are as follows: -

(d) Relief sought is as follows: -

VERIFICATION

I do hereby declare that above particulars and statements are correct and complete to the best of my knowledge and belief.

ACKNOWLEDGEMENT

Received from .................................. Memorandum of appeal in form ............................ For the period ................... Together with/without the papers and documents specified in item 11 of the memorandum of appeal.

The appeal number allotted is .................... of ...................

The memorandum shall be signed by the proprietor of the business, if an individual; by the karta, if an undivided family; by an authorised partner in the case of a firm; by a managing director, managing agent or principal executive officer or officer-in-charge in the case of a society, club, association, department of Government or local authority or by the manager, declared under rule 10.