The Chhattisgarh Value Added Tax Rules, 2006. - FORMS
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Body

FORM-75

[See rule 62-A(l)]

Application for grant of relief under sub-section (7) of section 49 of the Chhattisgarh Value Added Tax Act, 2005

To,

The secretary

Chhattisgarh Government

Commercial Taxes Department,
Mantralaya, D.K.S. Bhawan,
Raipur.

The applicant ....................................................................................a dealer holding registration certificate No ..........................................Under the Chhattisgarh Value Added Tax Act, 2005 and/or registration certificate No ......................... under the Central Sales Tax Act, 1956 having his place of business at ........................................in ............................. circle hereby apply for grant of relief under the provisions of sub section (7) of section 49 of the said act.

2. The particulars of order in respect of which relief is being sought are as follows:-

(a) Name & designation of the officer passing order ...

(b) Date of order ...

(i)	Period of assessment: .......................................................
(ii)	Amount of tax assessed, imposed interest and penalty -
	Tax	Interest	Penalty	Total
	Rs...................	Rs...................	Rs...................	Rs...................

(d) Particulars of the order passed where the order does not relate to assessment of tax and/or imposition of penalty: ...

3. Particulars of order passed in appeal and/or revision (to be furnished separately for each order):

(a) Name & designation of the appellate/revision authority .........................................

(b) Case No. and date of order .....................................................................................

........................................................................................................................................

4	(a)	Total tax, interest and penalty payable as per order of assessment/ appeal/revision where relief being sought is in respect of tax assessed, interest and penalty imposed:
		Tax	Interest	Penalty	Total
		Rs...................	Rs...................	Rs...................	Rs...................
	(b)	Total amount paid (with chalan No. and date) ...
	(c)	Balance of tax, interest and penalty payable at the time of making the application:
		Tax	Interest	Penalty	Total
		Rs...................	Rs...................	Rs...................	Rs...................
	(d)	Admitted tax, interest and penalty (provide grounds and reasons separately):
		Tax	Interest	Penalty	Total
		Rs...................	Rs...................	Rs...................	Rs...................
	(e)	Particulars of deposit of admitted tax, interest and penalty (with challan No. and date):
		Tax	Interest	Penalty	Total
		Rs...................	Rs...................	Rs...................	Rs...................

5. Question about the application of any relevant provision of law or error of fact apparent on face of the record or statement regarding necessary documents which could not be submitted (specify the question or the error of fact or the documents, as the case may be) ..........................................

....................................................................................................................................

5A Statement of the relevant facts having a bearing on the aforesaid question or the error of fact, as the case may be, or reasons for not submitting the necessary documents, along with arguments of the applicant

6. The applicant, therefore, prays ..............................................................................

....................................................................................................................................

(give particulars of the relief sought) and requests that the State Government may kindly direct the Commissioner to initiate proceedings under sub-section (1) of section 49 of the Chhattisgarh Value Added Tax Act, 2005.

	Signature .....................
Place .....................	Name .....................
Date .....................	Status .....................