Form of Application to Appellate Tribunal under sub-section (1) of section 35B or under sub-section (1) of section 35E of the Act

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....nal Appeal No. _______________________________ of 20.... ...........................................................................................Appellant/Applicant Versus ....................................................................................... Respondent   1. Assessee Code* Premises Code** PAN or UID***        Email Address  Phone No. ....

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....   -     -      Dated     -     -         6. Designation and address of the officer passing the decision or order in respect of which this appeal or application is being made. 7. State or Union territory and the Commissionerate in which the decision or order was made. 8. Date of receipt of the order referred ....

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....oned or allowed for the period of dispute     (iv) Whether no or less fine imposed?     (v) Whether no or less penalty imposed?     (vi) Market value of seized goods. 15. Whether any application for stay of the operation of the order challenged against has been made? 16. Subject matter of dispute in order of priority (please choose two items from the list below) ....

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....pplication. Statement of facts Grounds of appeal or application   Signature of the authorized officer, if any Signature of the appellant Note.- The appeal or application including the statement of facts and the grounds of appeal or application shall be filed in quadruplicate accompanied by an equal number of copies of the decision or order (one of which at least shall be a certified cop....