THE HIMACHAL PRADESH VALUE ADDED TAX RULES, 2005. FORMS
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FORM VAT- XXXVI

[See rule 77(1) (a)(ii)]

Form of memorandum of appeal to the Appellate Authorities other than the Tribunal, under section 30 (a) and (b) of the Himachal Pradesh Value Added Tax Act, 2005.

(Space for Court fee stamp)

Value of Court fee stamps affixed.

Before the

(Appellate Authority)

M/s

Appellant(s).

Versus

Respondent.

1. Assessment year

2. District in which assessment made

3. Authority passing the order in dispute

4. Date of passing order appealed against

5. Address to which notice may be sent to the appellant(s)

6. Address to which notice may be sent to the respondent

7. Relief claimed in appeal:

(a) Turnover determined by the Assessing Authority-

(b) If turnover is disputed: -

(i) Disputed turnover; and

(ii) Tax on disputed turnover;

(c) If rate of tax is disputed: -

(i) Turnover involved; and

(ii) Amount of tax disputed

(d) If the order or penalty is disputed:

(i) Section under which penalty imposed;

(ii) Amount of penalty in disputed; and

(iii) Amount of input tax credit in dispute.

(e) Any other relief claimed.

8. Whether the additional demand (i.e. tax, penalty or interest) created by the Assessing Authority has been deposited into the Government Treasury or not? TR No.

Date / / 2 0

9. Grounds of appeal (Full in here)

Signature of the Appellant(s) or his/their duly authorised agent.

Verification:

I/We____________. appellant(s) named in the above appeal do hereby declare that what is stated above from para 1 to ________ of the appeal, is true to the best of my/our knowledge and belief.

(Verified __________ this ______________ the day of 200 .

Signature of Appellant(s) or his/their duly authorised Agent.
_________________________________________________________________________________
Note. –
(i) The appeal shall be written on the standard water marked judicial paper and to be filled in triplicate specifying all the particulars given in this form .
(ii) It shall bear court-fee stamps worth Rs. .... contain a clear statement of facts and grounds of appeal briefly but clearly set-out and shall also state precisely the relief prayed for.
(iii) It shall be accompanied by : --
(a) the order in original against which it is made duly authenticated copy thereof unless the omission to do so or to produce such order or copy is explained at the time of presentation of memorandum of appeal to the satisfaction of the appellate authority; and
(b) proof of payment of tax (including interest payable) or of penalty or of both unless the inability to make payment of these amounts proved and unless a written prayer to that effect has been submitted alongwith the memorandum of appeal.
(iv) It shall be signed and verified by the appellant(s) or by an agent duly authorised by him/them in the behalf.

* Please indicate the designation of the authority, before whom the appeal is to be filled.
** Please indicate the place of the Appellate Authority, where his office court is situated.

	Signature of the Appellant(s) or his/their duly authorised agent.