MADHYA PRADESH VALUE ADDED TAX RULES, 2006 - FORMS
-

FORM 42

[See Rule 58(1)]

Memorandum of appeal against an order under the Madhya Pradesh Vat Act, 2002

To,

The Appellate Authority

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

FOR OFFICE USE

Appeal case No...........

Name and address of the Appellant
TIN (if any)
Order against which Appeal is preferred
Case Number
Period
Date of Order
Name of Authority who passed the Order
Under Section
Date of Communication of Order to appellant

(1) . The appellant above named is filing this appeal under section 46 of the Madhya Pradesh Vat Act, 2002, being aggrieved of the order mentioned above on following grounds :-

(Note: "Tick" mark the appropriate particulars (row), where relief is sought).

Particulars	As admitted by the appellant	As determined
Gross Turnover
Taxable Turnover
Tax Payable on Taxable Turnover
Taxable Purchase Price
Tax Payable on Taxable Purchase Price
Input Tax Rebate
Interest
Penalty
Against the order canceling the Registration Certificate
Fixation of security
Others ....................... (Specify it)

Extra Demand arising out of Order being appealed
Amount admitted by the appellant
Remaining amount
Amount required to be paid u/s 46 (5)
Amount paid	Challan No.	Date

(2). Notice of Demand and a certified copy of the order being appealed against are attached.

(3). The appeal is made on the following grounds :-

Grounds of Appeal

(4) The appellant ,therefore, prays for the following relief :-

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

( here give particulars of relief sought)

Date .......................

Place .......................

Signature of Appellant

(To be signed by the appellant or by an agent duly authorized in writing in this behalf by the appellant)

Declaration

I..............the appellant named above do hereby declare that what is stated in the memorandum of appeal is true to the best of my knowledge and belief.

Place .......................

Date .......................

Signature of Appellant

(To be signed by the appellant or by an agent duly authorized in writing in this behalf by the appellant)